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<br /> - Tashlun, Simmons, Sherill, d al.: +derljwrv and Mnwl GMnge , ~ lI7 ~
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<br /> mdyor emphysema. Althwgh sp ms of chmnic tmenettitia marijtwn smoke t. rhry were aceuatomed r0. which would
<br /> are believed to be reLled hirtopaths,.ogically to hypertrophy of not have progressed at the same ate with much more Drokon6ed
<br /> submucosal bronchial mttootuglands, alteratioru in dliated bran- exposure in rho fan of emerging adaptive mechanisms.
<br /> chin! epithelial Delia, sad hyperplasia of mucus•seeretingg~blet In conclusion, findings from the present long-term, follow-up '
<br /> cells (29), these symptoms of mucus hypenecrtion sro not study of hav)S habitual marijuana smokers afgtle agairut the
<br /> thought to be neceaarily linked to the progfpslve damage to concept that Mntinuing heavy use of marijuana is a significant
<br /> and narrowing of peripheral airwsys that accompany the evolu- risk factor for the development of COPD. These negative llnd-
<br /> tion of smoking-rehtted chronk obstructive airways disease (30). ingt, however, do not imply that regular tnarijusna smoking is
<br /> ~ It is possible that the wntraslina effects of marlluana and free of harmful pulmonary eflecu. Habf[ual marijuana smok-
<br /> tobxcca smoking is the present study an progresvtve changes in ing is essodued with a higher than expected prevalence of aymp•
<br /> lung function m(ghl be due to the trarked dlapauity in the quan- toms of chronic bronchitis p5, l6), as well as a higher incidence -
<br /> tlty orthe two subtrortce that were smoked: an avenge of 4.1 of acute broncbiW (!3). Moreover, other evidrna suggests that
<br /> joints/d in the mar(jwna•onty smokaa vertu 2Y.3 dgatatea/d marijwna troy be an important risk tacror for the development
<br /> In the tobacco-onlY smoken. Although the precise amount of of respiratory infection (9, 33), altd possibly [esDlratory malig-
<br /> marijuarusmoked cannot be accurakly determined because of narlcy (36), Further studies are required to document the real re-
<br /> the uncertain reUability of wl(reported usage and the common spiatory risks of this commonly smoked substance.
<br /> practice of tharittg joints, it is highly likely that the amount of 7Mauthors thankMr. hrodt t.te torMs tecMkaleastnatxe
<br /> actual usage of marijuana was fat less than that of to(maa f)n area Mr. n Dermend for Ms aswrann u, rncafny and wuuny partlc~wnu.
<br /> the other hand, dllaaenaa in Ohration of smoke thrrwgh the
<br /> mote aenwty paebed tobacco dgarata (In which txllulwe IUIm
<br /> were generally itteorpOreted) and the rnoro lonely packed, filar- ,
<br /> less mariJuana }alto, whkh ate usually stroked to a slnaUer butt 0.eUrNKts
<br /> length, apptnximatelydouble the Lv ykld of the ntarliuana joint I, Johettone, L. D., P. M.O'Mallsy, and 1. G. gasman. t99a. National
<br /> (Ig). Moreover, differences In smoking topography (larger tv- survey resulu en drug use ham The Monitoring tht Future Study,
<br /> mutative pull volume andisthaledvolumeofmarijuanasmoke 197f-97,vomml t.SaoondarySehaolStuderds.Nu;onallnanrute
<br /> and a a fourfold longer smoke rMmtlon time for toari;taaoa thaw on Drug Abuse. NIH ArbOcatipn No. 9s-)s09. V S. Oevernmtnt
<br /> for tobaao), added to the differetltw in smoke Gltntion, may Primint Olflcc, WaaMngtoo, DC.
<br /> resWt in a fourfold gta:ata retention of tar In the lung[ of nsarlju- t. lohnxone, L. D., P. M. OTaatley, and O. aachmaa. 1991. Nattonal
<br /> area smokers compared with smoken of a trompanble quandtY su^'~' "s"ka drag nee trpn 71u< Monnwlna tree Future Study,
<br /> of whole tobacco (7 q. This ampllflelion of the aposun of the 1975-9g. Volume II. Cogege Stuaeau and Yomg Aduha. National
<br /> Imtilutt oa ~ Alxua, NIH Poblintlan No.943g10. U.S tJpvvn.
<br /> lungs to the smoke of nurijtraoa starrows the gap bdweas a > tut- enrol Pnonoa OJAm. WWtington, DC.
<br /> told greater quantity Of repo[ted swage of tobaooo to perhapr 3. Hoffmann, D., D. X. 9runonnann. G. B. God. and 6. L. Wynder.
<br /> art only approximately twofold greater exposure of the lungs to 1971.Os tee eareinogwkity of marijuana smoke. Res. Adv. Phyro- i
<br /> the smoke from tobacco eomparad with maclJwtw. Thus, quan• altar. 9:67-d1. I
<br /> titative ditferentxs dOM may oOt enll[ely e7tDla{n lh! disparity a. Nowrm., M., F. MaU, D. w~ialu, M. Fwl, and T. SxM.19s2. Fnc-
<br /> inlon ltudinalrataofdectiminlun functfonbetwanthetao uoaaUoasM°pWryguW°wapaphbmassspcerromnrkcbar-
<br /> E g aaerkatioa aJtheneranl cemppatma k INrljaaM and tobaoeeaaW ka
<br /> typo of smokers. 8vidmce that qua111atlve diKetence between ceadawta. Chroarerop. YI8:141-ISO.
<br /> the two types Ol smOke may be m0[e important than QU0.ntiU- S. Roy, P. E., F. Magaan•La9oiam, N. A. Hvy, end al. Bouts. 1976.
<br /> rive difference with respect to tM development of COPD de• Chrome Inhalaeba of snarijuw and tobtao in doss: pulmoeuy '
<br /> rives from animal s[udka In which morphologkand physlologle pslbolep. Rtes. Co+nnrvn. Chem. Farhat. Phnmacd. 14:705-Jt7.
<br /> evidence of emphysema wan found in nu upaed for 6 mo to 6. ~b"'an' R• W ^ D. W, Haydaa, M. C. 8nude, artd H. Roscnkrarur- r
<br /> tobax0 BmOke, but ntN in ret3 ex for Ibe lam! period m n77. Chronic manbvana inhalauon toxicity In rob. Toakol. Appr.
<br /> smoke from a rnmppreble quantity
<br /> of marijuana (32). 7. Fklacsn
<br /> maR 3w„ 1, R. Baktt, W H. Rotrnkrantr. 1979, Pulmo•
<br /> Peripheral depoatllon of Inhaled partcle in the lung depends nary gthobgie chango to nb exposed to mar{juaM smoke for one
<br /> largely on particle size If partkulates In marijuana smoke were yen. Toasrol. App!. Phermdeol. 47;SS7-J66.
<br /> aubitantiagY larger than lhOU In tobacco smoke, it could be ar- 6. Fllgkl, S. E. G., T. F. &ab, D, P. TasNM, M. O. Peak. A. C. kalln,
<br /> S. F. AU, J. R. Ssiky, and W. Skkker, Jr. 1991. Marrjwns exposure
<br /> good that these partltvlates do not reach the small airways and sae n~~, akttatimnro
<br /> alveoli as efficiently as the submkroNe panlele t» tobacco primasa. Phoraracpl. 8ksrhan. 8ehav,
<br /> 10:6)T•d12.
<br /> smoke, and are therefore less Ukely to cause tluus injury n those 9. Hobo, G. L.. v. e. Pab+r, w. Ptreva, t. w. Ssea, W. C. Hines,
<br /> sites pllrnarllY affa~cted in COPD. thJ the sorbet hand, ANOdy- M. W. F4u, and d. C. Sorabergtr. 1980. Msrijvana, tarasYdragn• '
<br /> ramie measurements of partkles in marijtuna and tobacco Mbinol, and Wlmoeay amtMCtv41 defense. Char 1I:~t03-a10.
<br /> smoke, trade with laser Doppler veloclmet(y techniques, have 10. 0.ubin, V., and L. Comlut. 1975. 0.aplratory fvsctlon end semato4
<br /> confirmed that the lease median serodynatl»e diameta of use 08Y• !d Oanja ra ]arMla: A MNlal Mfluopological Study of
<br /> particles from the two types of amokearecomparebte (apprwtl- t t. CtCwp~ra~,
<br /> t7. S. n7wstum~etrwam~~ ~ Hasue. tt-to2.
<br /> peyeho-e8nipl rPaera o! bogderm swi-
<br /> matdy 0.3 µm) (33), thus relating this afttamWt• Arlene uw to n4 cases. rel. J. Addkr. 6:101!-!076.
<br /> The results of the present 8-yr study also contrast with find- 17. H+U, J. A. S. 1973. Testimoey in Marijuana-Huhlss Epidemic and to
<br /> ings from ashort-term prospaUve study (34) that demonstreted tmpaa oa Unhtd States StnWry. Jn HwrinBa of the Commiuet on
<br /> an accelereted daline in PPV, (approximately 314 of baseline) ten Jwkitry, United State Senates U.S. Croverameat Prinung Of-
<br /> i1n, Waahiogton, DC. 147-1St.
<br /> in 28 healthy male marlJwna smoken over ody 8 to 9 wk of 71. Heraardtt-adanps, 7•. t. w, Swatuon, tad W. 7. CaBglns. 197x. Pres. '
<br /> much heavier titan usual exptsstsre (mesa of S Jaints/s1, tompslred madon of patmoMry Nnotioa is «gular, heavy, tong-arm tnariiu-
<br /> whhtheir customary useotan averegeot 1 joirUtq. One month area smokers (alwtw:o• Arr. Rev. RaJrlr, D4. 113(Suppl.):100.
<br /> after eaaaatlon of tNs unuwaUy Aeavy was, the latter sub)cels r.. aouloveonr4, r. c., C. P. P.nayteaepwtss, II. AnIYMa, A. lr4o.,
<br /> exhibited a return op[~el~ FHYa [o baxllne, Ahhough It V dlffi- end C. Stefano. 1976. Eff~ssa orehronie tuuhlah was on medial aa-
<br /> cuh t0 explain the disctepanry between thew two prospective tun is M users eomperN with 18 coarrolr. Ann. MY. Acad. Srl.
<br /> 782:166-c71. f
<br /> atUdte, it b paulbk that the parlklpanls In the short-tQmltudy l!. Tuhkia, D. P., A. H. Coulson, Y. A. Clark, M. Shnmons, L. B. Spur-
<br /> (3d) experienced a tempOrerily steep step-dactlne in their dung g, pyann.0. H. Bpivty, tnd H. OonB. n87. Rpdratory sYmp•
<br /> function. otter auy expaure or tJ,dr tlcways to much troy toeu and tuns nu?.loo to Uaeltvtl,h.vyanoksn or meriivana aba,
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