Comparing cannabis with tobacco

Editor—Henry et al compare cannabis with tobacco.¹ Through the North East Council for Addictions (NECA) I have contact with cannabis users in the north east of England. Many young people (including 1% of schoolchildren) smoke at least five (up to 15) spliffs daily or inhale from “buckets.” Thus they obtain high concentrations of cannabis smoke containing all the constituents of tobacco smoke (except nicotine), including carbon monoxide, bronchial irritants, and carcinogens. Young people may start smoking at the age of 8 years, and more and more smokers are continuing for longer—into their 40s and 50s.

Unlike tobacco (nicotine) cannabinoids also have adverse psychiatric effects. A large amount of evidence shows that young and adolescent users are especially vulnerable to these effects.²,³ Those starting to use cannabis while in their early teens are more likely to suffer intellectual and emotional impairment; escalate to weekly or daily use; become dependent; progress to other illicit drugs; become anxious, depressed, and suicidal; and be involved in delinquency and crime than those starting later.⁴,⁵