Abstract
Even though marijuana smoke contains carcinogens and more tar than tobacco smoke and marijuana intoxication has been implicated as a risk factor for injuries, relatively little epidemiologic evidence has identified marijuana use as a risk factor for ill health. This study is the first to examine the health effects of smoking marijuana by comparing the medical experience of "daily" marijuana smokers who never smoked tobacco (n = 452) with a demographically similar group of nonsmokers of either substance (n = 450). Marijuana smoking status was determined during multiphasic health checkups at Kaiser Permanente medical centers between July 1979 and December 1985. Medical records were reviewed for as long as 2 years after the checkups. Frequent marijuana smokers had small increased risks of outpatient visits for respiratory illnesses (relative risk [RR] = 1.19; 95% confidence interval [CI] = 1.01, 1.41), injuries (RR = 1.32; CI = 1.10, 1.57), and other types of illnesses (RR = 1.09; CI = 1.02, 1.16) compared with nonsmokers; their risk of being admitted to a hospital was elevated but not statistically significant (RR = 1.51; CI = 0.93, 2.46). Analyses were adjusted for sex, age, race, education, marital status, and alcohol consumption. Daily marijuana smoking, even in the absence of tobacco, appeared to be associated with an elevated risk of health care use for various health problems.
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- Andréasson S., Allebeck P. Cannabis and mortality among young men: a longitudinal study of Swedish conscripts. Scand J Soc Med. 1990;18(1):9–15. doi: 10.1177/140349489001800102. [DOI] [PubMed] [Google Scholar]
- Andréasson S., Allebeck P., Engström A., Rydberg U. Cannabis and schizophrenia. A longitudinal study of Swedish conscripts. Lancet. 1987 Dec 26;2(8574):1483–1486. doi: 10.1016/s0140-6736(87)92620-1. [DOI] [PubMed] [Google Scholar]
- Armstrong M. A., Klatsky A. L. Alcohol use and later hospitalization experience. Med Care. 1989 Dec;27(12):1099–1108. doi: 10.1097/00005650-198912000-00002. [DOI] [PubMed] [Google Scholar]
- Bloom J. W., Kaltenborn W. T., Paoletti P., Camilli A., Lebowitz M. D. Respiratory effects of non-tobacco cigarettes. Br Med J (Clin Res Ed) 1987 Dec 12;295(6612):1516–1518. doi: 10.1136/bmj.295.6612.1516. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Friedman G. D., Seltzer C. C., Siegelaub A. B., Feldman R., Collen M. F. Smoking among white, black, and yellow men and women. Kaiser-Permanente multiphasic health examination data, 1964-1968. Am J Epidemiol. 1972 Jul;96(1):23–35. doi: 10.1093/oxfordjournals.aje.a121429. [DOI] [PubMed] [Google Scholar]
- Friedman G. D., Sidney S., Polen M. R. Smoking habits among multiphasic examinees, 1979 to 1984. West J Med. 1986 Nov;145(5):651–656. [PMC free article] [PubMed] [Google Scholar]
- Gieringer D. H. Marijuana, driving, and accident safety. J Psychoactive Drugs. 1988 Jan-Mar;20(1):93–101. doi: 10.1080/02791072.1988.10524377. [DOI] [PubMed] [Google Scholar]
- Gong H., Jr, Fligiel S., Tashkin D. P., Barbers R. G. Tracheobronchial changes in habitual, heavy smokers of marijuana with and without tobacco. Am Rev Respir Dis. 1987 Jul;136(1):142–149. doi: 10.1164/ajrccm/136.1.142. [DOI] [PubMed] [Google Scholar]
- Hiatt R. A., Friedman G. D. Characteristics of patients referred for treatment of end-stage renal disease in a defined population. Am J Public Health. 1982 Aug;72(8):829–833. doi: 10.2105/ajph.72.8.829. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Krieger N. Overcoming the absence of socioeconomic data in medical records: validation and application of a census-based methodology. Am J Public Health. 1992 May;82(5):703–710. doi: 10.2105/ajph.82.5.703. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Norton R., Colliver J. Prevalence and patterns of combined alcohol and marijuana use. J Stud Alcohol. 1988 Jul;49(4):378–380. doi: 10.15288/jsa.1988.49.378. [DOI] [PubMed] [Google Scholar]
- Rivara F. P., Mueller B. A., Fligner C. L., Luna G., Raisys V. A., Copass M., Reay D. T. Drug use in trauma victims. J Trauma. 1989 Apr;29(4):462–470. doi: 10.1097/00005373-198904000-00008. [DOI] [PubMed] [Google Scholar]
- Schwartz R. H. Marijuana: an overview. Pediatr Clin North Am. 1987 Apr;34(2):305–317. doi: 10.1016/s0031-3955(16)36216-2. [DOI] [PubMed] [Google Scholar]
- Soderstrom C. A., Trifillis A. L., Shankar B. S., Clark W. E., Cowley R. A. Marijuana and alcohol use among 1023 trauma patients. A prospective study. Arch Surg. 1988 Jun;123(6):733–737. doi: 10.1001/archsurg.1988.01400300079013. [DOI] [PubMed] [Google Scholar]
- Sutton L. R. The effects of alcohol, marihuana and their combination on driving ability. J Stud Alcohol. 1983 May;44(3):438–445. doi: 10.15288/jsa.1983.44.438. [DOI] [PubMed] [Google Scholar]
- Tashkin D. P., Coulson A. H., Clark V. A., Simmons M., Bourque L. B., Duann S., Spivey G. H., Gong H. Respiratory symptoms and lung function in habitual heavy smokers of marijuana alone, smokers of marijuana and tobacco, smokers of tobacco alone, and nonsmokers. Am Rev Respir Dis. 1987 Jan;135(1):209–216. doi: 10.1164/arrd.1987.135.1.209. [DOI] [PubMed] [Google Scholar]
- Tashkin D. P. Pulmonary complications of smoked substance abuse. West J Med. 1990 May;152(5):525–530. [PMC free article] [PubMed] [Google Scholar]
- Tashkin D. P., Shapiro B. J., Lee Y. E., Harper C. E. Subacute effects of heavy marihuana smoking on pulmonary function in healthy men. N Engl J Med. 1976 Jan 15;294(3):125–129. doi: 10.1056/NEJM197601152940302. [DOI] [PubMed] [Google Scholar]
- Williams A. F., Peat M. A., Crouch D. J., Wells J. K., Finkle B. S. Drugs in fatally injured young male drivers. Public Health Rep. 1985 Jan-Feb;100(1):19–25. [PMC free article] [PubMed] [Google Scholar]
- Wu T. C., Tashkin D. P., Djahed B., Rose J. E. Pulmonary hazards of smoking marijuana as compared with tobacco. N Engl J Med. 1988 Feb 11;318(6):347–351. doi: 10.1056/NEJM198802113180603. [DOI] [PubMed] [Google Scholar]
- Zuckerman B., Frank D. A., Hingson R., Amaro H., Levenson S. M., Kayne H., Parker S., Vinci R., Aboagye K., Fried L. E. Effects of maternal marijuana and cocaine use on fetal growth. N Engl J Med. 1989 Mar 23;320(12):762–768. doi: 10.1056/NEJM198903233201203. [DOI] [PubMed] [Google Scholar]