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Analysis: Cigarette Smoking Poses Greater Impact to Airway Health Than Cannabis
Davis, CA: Cannabis smoking and tobacco smoking appear to have disparate impacts on lung health, according to data published in the journal Respiratory Research.
Investigators affiliated with the University of California at Davis assessed the impact of tobacco smoke and cannabis smoke on airway health by analyzing subjects’ exhaled breath condensate (EBC).
They reported that cannabis consumers possessed breath profiles similar to those of non-smokers. By contrast, tobacco smokers possessed profiles with elevated levels of certain inflammatory biomarkers.
“Cigarettes upregulate these inflammatory fatty acids, but we didn’t see that nearly as much with marijuana and marijuana products,” one of the study’s authors said. “When we look at the signatures from the marijuana smokers, they look closer to non-users and non-smokers than the tobacco smokers, and that was a surprise to us.”
Prior studies have similarly determined that cannabis consumers are exposed to fewer harmful toxicants as compared to those who smoke tobacco cigarettes.
Numerous studies have concluded that cannabis smoke and tobacco smoke are not equally carcinogenic. Moreover, the use of vaporization technology, which heats herbal cannabis to a set temperature below the point of combustion, is associated with reduced exposure to toxic gasses and has been identified as a “safe and effective” cannabis delivery device in clinical trial settings.
Full text of the study, “Impacts of vaping and marijuana use on airway health as determined by exhaled breath condensate,” appears in Respiratory Research.
Study: Patients With Treatment-Resistant Epilepsy Improve Following Medical Cannabis Therapy
London, United Kingdom: Patients with refractory epilepsy report sustained improvements in their symptoms following the use of medical cannabis preparations, according to observational data published in the journal Brain and Behavior.
British investigators assessed the use of cannabis-based medicinal products (CBMPs) in a cohort of 134 patients with treatment-resistant epilepsy. (British health care providers may prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) Patients’ outcomes were assessed at one, three, and six months.
Medical cannabis treatment was associated with improvements in patient‐reported epilepsy‐specific outcomes, alongside improvements in anxiety, sleep quality, and health-related quality of life. Over 96 percent of study subjects reported no adverse events from cannabis treatment.
“Treatment with CBMPs was associated with an improvement in both epilepsy‐specific and general HRQoL [health-related quality of life] outcomes at one, three, and six months,” the study’s authors concluded. “This study shows the promising potential of CBMPs as an adjunctive treatment option in the management of TRE [treatment-resistant epilepsy.]”
In 2018, regulators at the US Food and Drug Administration granted market approval to Epidiolex, a prescription medicine containing a standardized formulation of plant-derived cannabidiol (CBD) for the treatment of two rare forms of epilepsy: Lennox-Gastaut syndrome and Dravet syndrome.
Other observational studies assessing the use of cannabis products among those enrolled in the UK Medical Cannabis Registry have reported them to be effective for patients diagnosed with cancer-related pain, anxiety, fibromyalgia, inflammatory bowel disease, hypermobility disorders, depression, migraine, multiple sclerosis, osteoarthritis, and inflammatory arthritis, among other conditions.
Full text of the study, “UK Medical Cannabis Registry: A clinical outcomes analysis for epilepsy,” appears in Brain and Behavior.
Analysis: Alcohol Poses a “Greater Threat to Road Safety” Than Cannabis
Vancouver, Canada: Alcohol is among the most frequently detected controlled substances identified in drivers following a motor vehicle accident and it “remains the greatest threat to road safety,” according to data published in the Journal of the American Medical Association (JAMA) Network Open.
Canadian researchers reviewed bloodwork data for over 8,300 drivers involved in a motor vehicle accident. Over half of the study’s participants tested positive for the presence of a controlled substance. Drivers were most likely to test positive for either depressants, cannabis, or alcohol – with cannabis being more common among younger drivers (ages 19 to 24).
However, most drivers who tested positive for the presence of THC in blood did so at nominal levels – indicating that their exposure may have been several hours or even days beforehand. (THC may remain present in the blood of more habitual consumers for several days following past exposure.) Only about three percent of participants tested positive for THC at elevated levels (THC ≥ 5 ng/mL).
“These statistics suggest that although more drivers test positive for THC, alcohol remains the greater threat to road safety,” the study’s authors concluded.
A prior Canadian study reported that drivers treated for traffic-related injuries are over three times as likely to test positive for elevated levels of alcohol (BAC ≥ 0.08 percent) than elevated levels of THC (THC ≥ 5 ng/mL).
Driving simulator studies report that cannabis administration is typically associated with compensatory driving behavior, such as decreased mean speed and increased mean following distance, whereas alcohol administration is associated with more aggressive driving behavior. Nevertheless, cannabis exposure can influence certain psychomotor skills necessary for safe driving, such as reaction time and drivers’ ability to maintain lane positioning.
A study conducted by the US National Highway Traffic Safety Administration reported that drivers who test positive for any amount of THC possess, on average, a far lower risk of being involved in a traffic collision than do drivers who test positive for alcohol at or near legal limits.
By contrast, drivers who test positive for the presence of both THC and alcohol in their system tend to possess significantly higher odds of being involved in a motor vehicle accident than do those who test positive for either substance alone.
Full text of the study, “Prevalence of impairing substance use in injured drivers,” appears in JAMA Network Open.
Texas: Appellate Court Strikes Down Voter-Approved Marijuana Ordinances
Austin, TX: A Texas appellate court issued a pair of rulings last week halting the implementation of voter-approved marijuana initiatives in the cities of Austin (population: 980,000) and San Marcos (population: 72,000).
Voters in both cities had overwhelmingly approved municipal ordinances in 2022 prohibiting local police officers from issuing citations or making arrests for minor marijuana possession offenses. Last year, Republican Attorney General Ken Paxton filed suit against Austin, San Marcos, and several other cities for adopting the measures. The Attorney General filed an additional suit against the city of Dallas in December, opining, “Cities cannot pick and choose which state laws they follow.”
Reversing a lower court judge’s ruling, judges on the Fifteenth Court of Appeals sided with the Attorney General and held that state law preempts San Marcos from enforcing its ordinance. Specifically, judges ruled: “Section 370.003 of the Local Government Code … prohibits local governments from putting up any barrier to the full enforcement of drug-related laws. Texas law gives local governments and law enforcement officers a panoply of tools — such as the authority to issue citations and arrests — to enforce drug laws. Section 370.003 prohibits the City of San Marcos from making a policy that takes any of those tools off the table.”
Judges issued a similar ruling days later, striking down Austin’s marijuana ordinance, finding, “Consistent with City of San Marcos, we conclude that the ordinance in this case is also preempted by state law.” That ruling also reversed a lower court judge’s decision.
Police in both cities are anticipated to revert to issuing marijuana-related citations and arrests while the cases continue to be litigated.
Similar ordinances are in effect in the cities of Elgin, Dallas, Denton, and Killeen. Earlier this year, city council members in Bastrop (population: 11,700) and Lockhart (population: 15,300) declined to implement voter-approved depenalization ordinances out of fear of litigation.
State law defines marijuana possession of two ounces or less as a criminal misdemeanor, punishable by up to 180 days in jail, a $2,000 fine, and a criminal record. According to data compiled by Texas NORML, police made an estimated 219,000 marijuana-related arrests between 2017 and 2021. Ninety-seven percent of those arrested were charged with possession only. Fifty-six percent of those arrested were under 25 years of age.
In addition to the Attorney General’s legal efforts, Texas lawmakers are also moving forward with legislation to prohibit localities from placing any future marijuana-related measures on the ballot. Specifically, Senate lawmakers recently approved SB 1870, which forbids voters from deciding upon any local ordinances that seek to decriminalize marijuana. The measure also prohibits cities and towns from adopting policies that do not “fully enforce” the state’s criminal marijuana laws.
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