Nicotine vs. Marijuana (cannabis)

Nicotine vs. Marijuana (cannabis)

John (Gold)
Joined: 18 Dec 2008, 23:57

03 May 2003, 06:18 #1

Comparing Cannabis with Tobacco


John A Henry, William L G Oldfield, Onn Min Kon
British Medical Journal 2003;326:942-943 (3 May)
Britain now has 13 million tobacco smokers. This number has been steadily decreasing due to public awareness of the harm caused by tobacco smoking. At the same time the number of cannabis smokers is increasing. Between 1999 and 2001, the number of 14-15 year olds who had tried cannabis rose from 19% to 29% in boys and 18% to 25% in girls, and a Home Office document estimates that 3.2 million people in Britain smoke cannabis. 1 2 However, the harmful effects of smoking cannabis are widely known and have recently been highlighted. 3 4 Although the active ingredients of the cannabis plant differ from those of the tobacco plant, each produces about 4000 chemicals when smoked and these are largely identical. Although cannabis cigarettes are smoked less frequently than nicotine cigarettes, their mode of inhalation is very different. Compared with smoking tobacco, smoking cannabis entails a two thirds larger puff volume, a one third larger inhaled volume, a fourfold longer time holding the breath, and a fivefold increase in concentrations of carboxyhaemoglobin.5 The products of combustion from cannabis are thus retained to a much higher degree. How is this likely to translate into adverse effects on health?

We already know that regular use of cannabis is associated with an increased incidence of mental illnesses, most notably schizophrenia and depression,4 but it is also worth examining its potential to cause other illnesses, especially those of the heart and respiratory system.

At present, there is an understandable dearth of epidemiological evidence of cardiopulmonary harm from cannabis, because its use is a relatively new phenomenon and its potency is changing. The amount of the main active constituent, tetrahydrocannabinol (THC), in cannabis has increased from about 0.5% 20 years ago to nearer 5% at present in Britain, whereas "Nederweed" (the variety smoked in the Netherlands) has an average of 10-11% tetrahydrocannabinol. At the same time little study has been undertaken of any concomitant change in the content of tar. Case-control studies are difficult to perform since cannabis cigarettes do not come in standard sizes, which makes dose-response relations difficult to establish. Furthermore, most users of cannabis also smoke tobacco, which makes it difficult to dissect out individual risks. As with tobacco, there will be a latent period between the onset of smoking and the development of lung damage, cardiovascular disease, or malignant change.

Tobacco smoking is responsible for 120 000 excess deaths each year in Britain, 46 000 from cancers, 34 000 from chronic respiratory disorders, and 40 000 from diseases of the heart and circulation. However, there are indications that smoked cannabis may cause similar effects to smoking tobacco, with many of them appearing at a younger age. Smoking cannabis causes chronic bronchitis, emphysema, and other lung disorders, which were recently summarised in a review released by the British Lung Foundation.3 A striking feature of cannabis smoking is that it is associated with bullous lung disease in young people.6 Inflammatory lung changes, chronic cough, and chest infections are similar to those in cigarette smokers, but may also be commoner in younger people.7-9 Premalignant changes have been shown in the pulmonary epithelium, and there are reports of lung, tongue, and other cancers in cannabis smokers.

Tetrahydrocannabinol has cardiovascular effects, and sudden deaths have been attributed to smoking cannabis.10 Myocardial infarction is 4.2 times more likely to occur within an hour of smoking cannabis.11 However, despite these alarming facts, there is no evidence at present on whether smoking cannabis contributes to the progression of coronary artery disease, as smoking cigarettes does. More studies of the cardiovascular and pulmonary effects of cannabis are essential.

It may be argued that the extrapolation from small numbers of individual studies to potential large scale effects amounts to scaremongering. For example, one could calculate that if cigarettes cause an annual excess of 120 000 deaths among 13 million smokers, the corresponding figure for deaths among 3.2 million cannabis smokers would be 30 000, assuming equality of effect. Even if the number of deaths attributable to cannabis turned out to be a fraction of that figure, smoking cannabis would still be a major public health hazard. However, when the likely mental health burden is added to the potential for morbidity and premature death from cardiopulmonary disease, these signals cannot be ignored. A recent comment said that prevention and cessation are the two principal strategies in the battle against tobacco.12 At present, there is no battle against cannabis and no clear public health message.



Competing interests: None declared.
Bibliography
1. Schools Health Education Unit. Young people in 2001. Exeter , 2002. www.sheu.org.uk/pubs/yp01/yp01.htm [accessed 18 Feb 2003].
2. Bramley-Harker E. Sizing the UK market for illicit drugs. London: Home Office Research, Development and Statistics Directorate, 2001. www.homeoffice.gov.uk/rds/pdfs/occ74-drugs.pdf (accessed 18 Feb 2003). (Occasional paper No. 74.)
3. British Lung Foundation. Cannabis and the lungs. London: British Lung Foundation, 2002. www.lunguk.org/news/a_smoking_gun.pdf (accessed 18 Feb 2003)
4. Rey JM, Tennant CC. Cannabis and mental health. BMJ 2002; 325: 1183-1184.
5. Wu TC, Tashkin DP, Rose JE, Djahed B. Influence of marijuana potency and amount of cigarette consumed on marijuana smoking pattern. J Psychoactive Drugs 1988; 20: 43-46.
6. Johnson MK, Smith RP, Morrison D, Laszlo G, White RJ. Large lung bullae in marijuana smokers. Thorax 2000; 55: 340-342.
7. Roth MD, Arora A, Barsky SH, Kleerup EC, Simmons M, Tashkin DP. Airway inflammation in young marijuana and tobacco smokers. Am J Resp Crit Care Med 1998; 157: 928-937.
8. Fligiel SE, Roth MD, Kleerup EC, Barsky SH, Simmons MS, Tashkin DP. Tracheobronchial histopathology in habitual smokers of cocaine, marijuana, and/or tobacco. Chest 1997; 112: 319-326
9. Bloom JW, Kaltenborn WT, Paoletti P, Camilli A, Lebowitz MD. Respiratory effects of non-tobacco cigarettes. BMJ 1987; 295: 1516-1518
10. Bachs L, Morland H. Acute cardiovascular fatalities following cannabis use. Forensic Sci Int 2001; 124: 200-203
11. Mittleman MA, Lewis RA, Maclure M, Sherwood JB, Muller JE. Triggering myocardial infarction by marijuana. Circulation 2001; 103: 2805-2809
12. Schroeder SA. Conflicting dispatches from the tobacco wars. N Engl J Med 2002; 347: 1106-1109


Responses sent to the BMJ about the above article

Sir,
I read with interest the editorial by Henry et al. I should like to address the fact that cannabis use is as they say associated with an increased incidence of mental illness however the casual relationship remains to be proven and to follow on in the same sentence to state 'to examine its potential to 'cause' other illnesses is imprecise and may be read that we have excepted the evidence that cannabis does indeed cause mental illness. No such casual evidence exists.

The paper by Bachs et al relating to acute cardiovascular fatalities following cannabis use is far again from conclusiveand the authours themselves were cautious to stress the , and I quote , possible nature of the association. Again the text of the Henry paper reads 'attributed' clearly there is a difference again between cause and association.

In addition one must remember that many users of cannaboids are staunch antismokers and instead prefer to cook so called 'hash cakes'I wonder how many of the schoolchildren who admitted taking cannabis had done this in preference to smoking. Indeed if users are eating rather than smoking then the putative causal relationship is many times less likely.
Andrew Parfitt,
Consultant A and E

A recent editorial suggested that in the future as many as 30,000 deaths a year in Britain may be caused by smoking cannabis(1). But this conclusion was not based on any new scientific evidence and the arithmetic appears to be based on a series of questionable assumptions.
Cannabis smoke does contain many of the same poisonous substances that are found in tobacco smoke and cannabis smokers deposit more tar in their lungs than cigarette smokers because they inhale more deeply and tend to hold their breath(2). But to expose the lungs to the same amount of tar as an average 15 - 20 a day cigarette smoker, cannabis users would have to smoke 4-5 times a day every day of the week. In fact surveys of young cannabis users in Britain suggest that very few fall into this category ¨C a large majority are occasional ¡°weekend¡± users, and even among more frequent users few fall into the high use category of 4-5 times a day(3). It is obviously impossible to get accurate statistics on the numbers of daily cannabis users, but the figure of 3.2 million in Britain cited by the authors of the editorial is far too high. It is also difficult to get accurate scientific data on the effects of regular cannabis use on the lungs because many users mix cannabis resin with tobacco. But studies of cannabis-only smokers in California showed that they do tend to develop signs of chronic bronchitis ¨C but there is no evidence that this progresses to more severe lung diseases such as emphysema or lung cancer(4).

An important factor is that unlike cigarette smokers most cannabis smokers tend to quit when they reach their 30¡¯s. Long term surveys of cigarette smokers showed that those who quit before the age of 35 had only a very slightly increased risk of lung cancer(5). The risk of developing lung cancer depends far more on the duration of smoking than on the number of cigarettes consumed. Thus smoking 40 cigarettes a day as opposed to 20 doubles the risk of lung cancer, but smoking for 30 years as opposed to 15 years increases the risk by 20-fold. If the risks of cannabis smoking equate to those of tobacco and the majority of users give up before the age of 35 they may run little additional medical risk.

The BMJ authors also suggested that the more potent forms of cannabis that are sometimes available nowadays somehow carry an increased medical risk ¨C but one could argue exactly the opposite. THC, the active chemical ingredient in herbal cannabis, is not known to be harmful to the lungs ¨C indeed there is some scientific evidence that it may possess anti -cancer properties(6). It is also known that users when exposed to more potent forms of cannabis adjust their smoking behaviour to inhale less frequently and less deeply, while obtaining the same amount of THC (2,7). The users of potent forms of herbal cannabis may thus benefit from a reduced exposure to potentially harmful tar.

Finally, the BMJ authors added some gratuitous additional warnings about the dangerous effects of cannabis on the heart. It is true that cannabis tends to stimulate the heart and it could potentially be harmful to people who have a pre-existing heart disease, but the published scientific data has not shown this to be a serious medical problem. The two publications cited are based on very small samples and circumstantial data. In Britain virtually no cases of drug-related death due to cannabis have been reported in recent years ¨C despite our strict national system for reporting substance abuse-related deaths.

While cannabis cannot be considered to be completely harmless and it does cause adverse effects on the lungs ¨C the sort of scientific/medical scaremongering indulged in by the authors of this editorial is completely unscientific and fails to advance the public health debate about cannabis. Their arithmetic simply does not add up. Instead they help to bring science into further disrepute, and make it less likely that young people will listen seriously to any health message concerned with drugs.
Professor Les Iversen PhD FRS Department of Pharmacology University of Oxford
References

1. Henry JA, Oldfield WLG, Min Kon O. Comparing cannabis with tobacco. BMJ 2003; 326: 942-943
2. Wu TC, Tashkin DP, Rose JE, Djahed B. Influence of marijuana potency and amount of cigarette consumed on marijuana smoking pattern. J.Psychoactive Drugs 1988; 20: 43-46
3. Iversen LL The Science of Marijuana, 2000, pp215-220; Oxford University Press, New York
4. Tashkin DP, Baldwin GC, Sarafian T, Dubinett S, Roth MD. Respiratory and immunological consequences of marijuana smoking. J Clin Pharmacol 2002; 42 Suppl 11:71-81S
5. Doll RR, Peto K, Wheatley K, Gray R, Stherland I. Mortality in relation to smoking: 40 years observations on male British doctors. BMJ 1994; 309: 901-910
6. Guzm¨¢n N, S¨¢nchez C,Galve-Roperh I. J.Mol.Med.2001; 78: 613-625
7. Matthias P, Tashkin DP, Marques-Magallanes JA, Wilkins JN, Simmons S. Effects of varying marijuana potency on deposition of tar and D9-THC in the lung during smoking. Pharmacol.Biochem.Behav. 1997; 58: 1145-50


Henry, Oldfield, and Kon sounded the alarm about potential lung problems in cannabis smokers. 1 As these authors mention despite their concerns, large studies still show little lung damage in those who smoke cannabis and not tobacco2. Nevertheless, new information may allay the fears of some readers worried about the plant's pulmonary effects.
First, the reported increase in cannabis potency does not translate into greater risk for pulmonary problems. Though many authors argue that estimates from the 1970s of .5% THC are clearly inaccurate, most believe current data suggesting that THC concentrations average near 5% and can reach as high as 20%. The stronger cannabis, however, yields less tar per unit of THC than weaker cannabis, and leads to less deposition of tar into the lungs of smokers 3.
Because problem users are often reluctant to abstain from cannabis completely, health care professionals might suggest ways to increase the safety of the drug. The common habit of holding smoke in the lungs for extended periods provides greater exposure to noxious materials. This practice should be actively discouraged. At least 3 studies show that longer breathhold durations have little meaningful impact on intoxication 4.

In addition, vaporizing cannabis rather than smoking it can create the same subjective effects with no exposure to many toxins.5 Vaporizers have become readily available and relatively inexpensive. These machines have the potential to eliminate pulmonary problems associated with cannabis use. Smoking small amounts of potent cannabis through a vaporizer and refraining from holding smoke in the lungs presents little risk of lung troubles.
Mitchell Earleywine, associate professor of clinical science Department of Psychology, University of Southern California, Los Angeles, CA, USA 90089-1061 earleyw@usc.edu
1. Henry, J. A., Oldfield, W. L. G., Kon, O. M. Comparing cannabis with tobacco, BMJ 2003; 326:942-943.

2. Polen, M. R. Health care use by frequent marijuana smokers who do not smoke tobacco. West J Med 1993; 158: 596-601.

3. Matthias, P., Tashkin, D. P., Marques-Magallanes, J.A., Wilkins, J. N. & Simmons, M.S. Effects of varying marijuana potency on deposition of tar and delta9-THC in the lung during smoking. Pharmacol Biochem Behav 1993; 58: 1145-1150.

4. Azorlosa, J. L., Greenwald, M. K., Stitzer, M. L. Marijuana smoking: effects of varying puff volume and breathhold duration. J Pharmacol Exp Ther 1995; 272: 560-569.

5. McPartland, J.M., Pruitt, P.,L. Medical marijuana and its use by the immuno-compromised. Altern Ther Health Med 1997; 3:39-45.

The brief editorial, "Comparing Cannabis with Tobacco" by Henry, Oldfield and Kon (British Medical Journal, May 3) is so full of gross inaccuracies, unsupported assumptions and unjustified speculation that, were it not for the fact that it decries chronic use of cannabis, it's unlikely a reputable journal would publish it.
For starters, there is considerable evidence that cannabis provides significant relief of a wide variety of troublesome symptoms; given fierce US prohibition policy (as reflected in United Nations treaties), data supporting that contention has been understandably difficult to gather and publish. Beyond that, the editorial clearly infers that the only way cannabs is used is by smoking in the manner the authors describe at some length. Actually, that manner of smoking, while still too popular, was fokelore based on erroneous assumptions; it has been repudiated in responsible articles for years.

There are actually many ways cannabis can be ingested other than smoking; perhaps the best is vaporization, a technique endorsed by knowledgeable clinicians because it preserves the rapid cerebral feedback that allows a user to avoid unwanted intoxication and also largely eliminates the harms of smoking.1

This brief response permits only passing reference to work I am now engaged in-- thanks to the passage of a medical cannabis initiative in California (Proposition 215). That law, passed in 1996, has effectively allowed certain chronic users to 'come in from the cold ' as it were. Systematic interviews of several hundred reveal them to be a very specific population which is surprisingly uniform in the way they became chronic users, their lifetime use of other psychotropic agents (including alcohol and tobacco), and also in their belief that sustained moderate use of cannabis has afforded them considerable benefit over years and-- in many cases-- decades

Seen in that context, the editorial is a throwback to "Reefer Madness," the mid-Thirties American propaganda campaign which eventually led to creation of a huge criminal market for one the most versatile and useful plants ever cultivated. It's unlikely that the editorial will deter that market significantly, but it certainly contributes to the confusion precluding adoption of an intelligent drug policy; one based on factual evidence rather than empty dogma.

1) D. Gieringer, "Cannabis Vaporization: A Promising Strategy for Smoke Harm Reduction," Journal of Cannabis Therapeutics Vol. 1#3-4: 153-70 (2001)

Competing interests: Member of several organizations advocating drug policy reform.

Thomas J O'Connell MD
'Comparing cannabis with tobacco'. Henry JA, Oldfield WLG, Kon OM. BMJ (2003) 326: 942-943
I would commend these authors on using the correct scientific term cannabis, unlike some colleagues who seem to prefer terms allegedly introduced by governments rather than scientists.

That said, this is one of the most un-scientific BMJ articles I have read. Despite their being opposites in most respects, Henry and co-authors try to compare cannabis and tobacco. While both are common psychoactive drugs, cannabis is a relaxant, tobacco a partial-stimulant. One is highly addicting, the other is not. One has been prescribed by physicians down the ages and continues to be recommended in certain clinical circumstances by doctors of good repute. Hence a 'comparison' is an intriguing concept unless clearly stated objectives are being examined (eg. dependency, mortality, side effects, beneficial effects, etc). .

Cannabis has an extremely low mortality while tobacco's toll is legion. Nearly 20,000 Australians die from tobacco related disease each year with few if any cannabis reported deaths.

When examining any drug, one looks for costs and benefits but these authors have only looked for 'costs' and, for cannabis, then they can only point to 'associations'. Even if cannabis actually caused some cases of mental disease (and it does induce dependency in a small proportion of heavy users), the drug may also alleviate some conditions such as anxiety, insomnia, depression, anorexia or chronic pains.

These authors state that it might be seen as 'scaremongering' to speculate on the basis of cannabis being of equal toxicity as tobacco ... yet they go ahead and do just that: "the corresponding figure for deaths among 3.2 million cannabis smokers would be 30,000" [annually in the UK]. Can these authors be serious when no group of suspected cases is yet to be reported after the drug has been used for thousands of years in western society? If they are interested in speculation, why don't they look at alcohol consumption in cannabis smokers?

Quite apart from their tenuous position in trying to point to cardiovascular complications which may occur with smoking cannabis, they make numerous questionable and unreferenced statements in their paper including the howler about cannabis strength increasing over the years (by 10 to 20 times!). Even if this were true, it would mean less by-products for the same amount of drug and thus possibly safer smoking. Also, cannabis can be taken orally with no effect on the lungs at all, but these authors do not canvass that issue, nor other harm reduction steps. Without references, they also quote "Nederweed" ('the variety smoked in the Netherlands') which they claim has an *average* of 10-11% tetrahydrocannabinol. This is obviously unhelpful since Holland, like other countries, has a variety of cannabis and resins available on the market, including cannabis cookies.

These authors make much of the increase in cannabis use and the reductions in tobacco consumption in recent years. However, they are not open enough to discuss the legal status of the drugs. If these authors are honestly concerned about harms from cannabis then it is hard to understand why they would ignore the spectacular failing of current prohibitions in addressing these harms. The results of long term cannabis decriminalization (eg. South Australia, Holland) are equally ignored by these 'scaremongers' (to use their own term).
Andrew Byrne, Dependency Physician

Dear Sir,
Oldfield and Kon observe, quite correctly, that cannabis consumption is rising while tobacco consumption is declining in the United Kingdom. This is true in many other countries and has been the case now for several decades. These developments are no accident. In numerous countries, achieving a decline in tobacco consumption required a steadfast committment to policy based on research evidence concerning which prevention measures work and which do not. The critical public health achievment of tobacco control has been won despite the immense power of the tobacco industry. In contrast, vast resources have been allocated to law enforcement efforts to reduce cannabis smoking with very little benefit identifiable and much in the way of unintended adverse consequences. Surely if there is a lesson to be learnt from this, it is that those who are concerned to reduce the prevalence of cannabis smoking should support the same measures that worked so well for tobacco. Tobacco control has been achieved within the framework of a taxed and regulated drug. There is virtually no support among tobacco control experts for the re-introduction of tobacco prohibition. A sustained decline in cannabis consumption will only be achievable when the drug is taxed and regulated like tobacco and policy is based on evidence.

The retention of cannabis prohibition despite the lack of success and the high financial and social cost of this policy, has required a 'talking up' of the toxic effects of cannabis. Cannabis is not by any means innocuous. But the health and other adverse consequences of cannabis are dwarfed by those of alcohol and tobacco. This point was made by several reputable authors in a recent WHO review that was dropped following political pressure.

One of the many costs of cannabis prohibition is the publication in reputable medical journals of highly questionable commentary on the relattive toxicity of cannabis.

Yours sincerely,

Dr Alex Wodak,

Director, Alcohol and Drug Service St. Vincent's Hospital, Darlinghurst, NSW 2010 Australia


Sir, I read with interest the editorial of Henry et al (1). Tobacco smoking is the greatest evil in lung cancer risk across 90% of all lung cancer cases. However, evidence suggested that cannabis use is not far behind. Recent trends in lung cancer mortality in the United States showed that there is an apparent 'birth cohort' effect in lung cancer risk after 1950 (2). The authors' have speculated that this observation may be attributed to cannabis smoking, in addition to changing tobacco-smoking habits across the populations.
Interestingly, one of the cannabinoids (delta 9-tetrahydrocannabinol) has shown to have an apparent beneficial effect on lung adenocarcinoma in animal models (3). By contrast, there is accumulating evidence of histopathologic and molecular changes in lung tissue of smokers, suggesting cannabis could increase lung cancer risk in humans (4). Is this a paradoxical observation? In addition, cannabis smoke contains many of the same carcinogens found in cigarettes, as pointed out by Henry et al (1).

Until the cause-effect relation of cannabis on human health, including lung cancer, is clear, is it 'scientific' or rather 'premature' to contemplate on cannabis cessation programmes in line with tobacco smoking programmes?

References

1. Henry JA, Oldfield WLG, Kon OM. BMJ 2003: 326: 942-3.
2. Jemal A, Chu KC, Tarone RE. Recent trends in lung cancer mortality in the United States. J Natl Cancer Inst 2001; 93: 277-83.
3. Munson AE, Harris LS, Friedman MA, Dewey WL, Carchman RA. Antineoplastic activity of cannabinoids. J Natl Cancer Inst 1975; 55: 597- 602.
4. Barsky SH, Roth MD, Kleerup EC, Simmons M, Tashkin DP. Histopathologic and molecular alternations in bronchial epithelium in habitual smokers of marijuana, cocaine and/or tobacco. J Natl Cancer Inst 1998; 90: 1198-205.

Zubair Kabir,
Research Fellow
Competing interests: ZK is a Research Fellow in Lung Cancer Epidemiology at the University of Dublin (Trinity College).


To the editorial board
Dear Sir,
I was surprised at some of the things said in the recent BMJ editorial. "Can you compare cannabis with tobacco?"
In future, when someone editorialises on such a contentious issue, could you please ask them to declare their political allegiance. In particular do Dr Henry and Dr Oldfield support the current practice of criminalising cannabis smokers? Should cannabis smokers be locked up in prison? This is an issue they ignore but it is the major public policy used to discourage cannabis use. In fact, the editorial states that "At present, there is no battle against cannabis and no clear public health message." Are they unaware that unauthorised possession of cannabis is a criminal offence? Does a 'War on Drugs' not 'battle' against cannabis?
Cannabis and Tobacco can't be compared in this way.
In a ranking of addictivity of 6 drugs both Henningfield (NIDA) and Benowitz (UCSF) ranked Nicotine as the most addictive and marijuana as the least addictive (comparing Nicotine, Heroin, Cocaine, Alcohol, Caffeine and Marijuana). [Hilts, P.J. The New York Times 2-Aug-94, C3]
The writer states that "there are indications that smoked cannabis may cause similar effects to smoking tobacco, with many of them appearing at a younger age"
But cannabis smokers
* smoke fat less than cigarette smokers (when indulging).
* do not generally smoke everyday
* generally stop smoking as they progress out of their teens as it is easy to stop smoking cannabis because there is no physical addiction.
While tobacco smokers:
* generally smoke at least 20 a day (when indulging)
* do smoke everyday
* often smoke for life and find it difficult to stop smoking.
It is impossible for me to understand how the writers arrive at their 'comparison', given that one of them is a consultant, specialist registrar at a Department of Respiratory Medicine.
I'm all in favour of improving research into the harmful effects of smoking and of discouraging the smoking of anything but scaremongering and/or criminalisation are not the way to do it.
Competing interests: None declared
Mark Pawelek

Ms. Brett,
If concern for our children's future is indeed your primary motive, should you not include the harm done to our children who must now somehow try to succeed in life now with the ball and chain of a criminal record with them.. "Them" is our children. The "outcast" status that a criminal record bestows on our brothers, mothers and fathers, and of course our children, and it's effect on their future needs no study to determine how destructive it is on their lives. It is severe. And this is obvious. There is no controversy here. It is common sense.
I snipped your references because you referenced nothing. You gave an opinion.....your own opinion. You stated that cannabis "impairs" the chemical transmission system. You also inserted the word "badly". Which study used those value judgements?. Interfering with the bodies own chemistry or natural functions is how drugs work. All drugs. Aspirin and caffeine for example. This interference is not inherently a bad thing, as you seem to be suggesting.
No, it's time that reality rather than blind hysteria is brought to the subject of drugs. For example; have you ever been given a shot of morphine in the hospital? Did you know that heroin is in fact nothing more than morphine that has been slightly altered so as to pass the blood:brain barrier more quickly, providing a faster onset of the morphine? . Yes... morphine. The heroin, once past the blood brain barrier reverts back to morphine and from that point on, the high is indistinguishable from morphine because it is morphine. My point is that the demonization of heroin has succeeded in turning a useful drug into something that no one of their right mind would ever want to do. Well unfortunately, millions of people, and perhaps you, although convinced that heroin will kill them and is immediately addictive, etc, have in fact, for all intents and purposes, already done it.
That is the power of misinformation Ms. Brett. Thousands of people in jail for doing a substance that doctors are giving to patients, in the hospitals, by the bathtubs full, daily.
If you want to help our children, please rethink your stance on drugs. Driving the users of the seriously harmful drugs like the stimulants, (methamphetamine and cocaine) into back-alleys only exacerbates the problem. Drugs will not go away using laws. Countries that summarily execute drug-dealers or users have not stopped it. Drugs, whether you like it or not, are here to stay. All that can be done is to reduce the damage done. Common sense.
Sincerely,
Gary Williams
Mycologist and Harm Reduction Advocate
Competing interests: None declared

Editor, The editorial by Henry et al on cannabis is quite simply the most unbalanced and inappropriate piece of writing on this subject I have seen for some time. It puts together questionable assumptions, wooly science and urban myths (such as the "potency" of modern cannabis) which conflict with the vast majority of reputable current literature. One must ask what the authors reasons were for this article - it could hardly have been to educate the profession.
And, as Wodak notes, such scare tactics are not likely to do much good - entrenching hardline prohibitionist policy will, based upon 50 years of evidence (rather than rhetoric), only increase the damage from cannabis, most of which stems from its prohibition, not the drug itself.
Ashton raises the issue of 8 year old smokers without, apparently, asking how these kids come to have the drug, where their parents or teachers are, and whether these kids may have problems apart from cannabis use which may impact upon their health and wellbeing. Easier to blame the drug, perhaps but that gets us.......where? More prohibition, more money spent on a counterproductive war on drugs, and thus not on schools, welfare, equity, justice. Even if cannabis where the cause of these kids problems, do the current policies and practices prevent these problems (clearly, no) or worsen them (probably, yes).
Canada, The Netherlands and many other jurisdictions have broken away from the mesmerised trance that chanting pro-prohibition mantras induces in many otherwise thoughtful people and institutions. Time for Britain, and Australia, to do likewise.
Rod MacQueen,
Clinical Director, A&OD, Mid Western Area Health Service; VMO, Lyndon Detox Unit
Competing interests: None declared

There are serious problems and misunderstandings with this editorial. I would like to list several:
1. Most of the mortality risk associated with tobacco use arises from sustained use over several decades, and the risks increase sharply as lifetime exposure accumulates. The importance of lifetime exposure was underlined in a major study of tobacco smokers in 2000 which found that: "People who stop smoking, even well into middle age, avoid most of their subsequent risk of lung cancer, and stopping before middle age avoids more than 90% of the risk attributable to tobacco." [1]. A similar pattern should be expected for CHD and COPD - the two other major tobacco-related fatal diseases.
To the extent there is data on use of cannabis, it suggests that most users (so far) quit using it in their 30s. In the OPCS Psychiatric Morbidity Survey carried out in 1993, some 14% of adults aged 16-24 were users, but the figure dropped to 2% among those aged 35-44, and was less than 0.5% in people aged over 45. There may be cohort effects operating here, and it is possible that today's young people will have longer cannabis careers, but at present what this seems to indicate is that few people have accumulated 20 or more years of continuous use.
The very high risks due to tobacco use ultimately arise from its addictiveness, which causes many tobacco smokers to continue to smoke well after they would choose to stop. Over 70% of current users say they would like to stop, and over 80% regret ever starting: a sure indicator of addiction sustaining long term and heavy use. As cannabis has very different dependency characteristics (it is much less addictive) then its pattern of use is different most users smoke less and quit earlier.
2. Completely incompatible characterisations of the user population are used in the editorial. The figure of 13 million tobacco users is determined by those answering 'yes' to the question 'do you smoke nowadays'. In practice over 80% of these are daily users and the average consumption is just over 15 cigarettes per day per smoker. Tobacco / nicotine is an intensive drug-using syndrome for most of its users. In contrast, the Home Office figure of 3.2 million users quoted for cannabis is 'use in the last 12 months'. The figure for use in the last month (not quoted in the editorial) is 2,062,000. The Home Office does not assess how many use cannabis daily, but it will be very substantially less. Again the reason is grounded in addictiveness - the lower dependency-forming characteristics of cannabis allow for more occasional use than cigarette smoking, which generally consolidates into a powerful addiction needing constant attention by the user.
3. The point that THC concentrations have increased by a factor of ten over the last twenty years is dubious as a point of fact, but more importantly, it is completely misinterpreted. Put bluntly, a ten-fold increase in THC concentration does not mean that modern users are ten times as stoned as in the past. Users of both cannabis and nicotine control their drug exposure by varying how much smoke they inhale and retain. Higher concentrations of THC may therefore lead to LOWER smoke inhalation for a given drug exposure. This is well understood for tobacco (and the reason why 'light' cigarettes are such a fraud) but not well studied for cannabis - however it is unlikely that users do not control their intake or they would be ten times as stoned as they were 20 years ago. Ironically, the concern raised in the editorial about different puff volumes for cannabis (based on 1987 data, by the way) may actually have been alleviated by the asserted increase in THC concentration in the drugs now in use leading to lower smoke exposure as users control their dose by taking fewer and lighter puffs.
4. The derivation of the figure of 30,000 deaths is so facile it shouldn't really have been written down. At this stage, there is only limited evidence linking cannabis use to the big tobacco-related killers - cancer, CHD and COPD. While these links should be expected, the magnitude of the risk to the user (simply assumed to be equivalent to tobacco in the derivation of the 30,000 figure) will depend on a variety of factors, in particular the lifetime exposure and patterns of use - and these are very different indeed. Very few of the 120,000 smoking-related deaths occur in people under 40, yet hardly any of the users of cannabis are over 40 - so who are the 30,000 dying? Given that the smoking careers differ so much, and the usage patterns are so different, the estimate of 30,000 deaths is ridiculous. Qualifying the calculation by saying it may be 'a fraction' of that adds nothing if we don't know whether the fraction in question is one half or one-thousandth. It does leave the media-sensitive headline number in place and puts the figure into the public domain as the only estimate. It is sure to be used by those with agendas other than forming rational evidence-based insights into public health issues.
5. The case has not made that cannabis is a 'major public health hazard' as asserted in the editorial. It is certainly not harmless and the authors suggest several harmful effects. But there is a continuum between 'harmless' and 'major public health hazard' and simply showing there are dangers is insufficient to place a phenomenon like cannabis on that continuum. Most credible reviews to date have tended to suggest limited public health impacts. For example, the Advisory Council on Misuse of Drugs [2], concluded in March 2002 after a thorough review of the evidence... "The high use of cannabis is not associated with major health problems for the individual or society." There is always a need to challenge such assessments, but any challenge has to be credible.
6. To say there is no battle against cannabis when it is a criminal offence (even after reclassification) to use it, grow it or sell it is absurd. I agree that more could be done to promote understanding of the harm it causes and I hope the findings about the link between cannabis schizophrenia, which appear to settle the question over the direction of causation, are filtering through to users. However, one reason why health promotion efforts sometimes fail is the lack of credibility of the arguments presented to users. The casually fabricated mortality figure and 'war-on-drugs' rhetoric of the editorial are wholly counter-productive in that regard. (Incidentally, the illegal status of cannabis is a barrier to wider and better understanding of its risks because it denies opportunities for mandatory labelling and inserts in the packaging.)
Finally, the finding that cannabis is not harmless is not new and adds little to the important and highly-charged debate about its legal status, which is really about societal management of personal risk and relationship between the state and the individual. Understanding of addictiveness and its impact on personal choice and patterns of consumption are crucial in positioning different drugs, and entirely absent from the analysis presented in the editorial. Sadly, editorials like this play well in a particularly rabid section of the popular media, which has no interest in a thoughtful societal response to all drugs based on harm-reduction, respect for civil liberties and cost effectiveness. Rather than fanning the flames of tabloid ignorance, the BMJ is usually a beacon of rational and measured debate on these vital issues. I fear the editorial guard may have been down on this one.
Clive Bates
I don't think it is a competing interest, but in the interest of clarity I would like to disclose that I was Director of Action on Smoking and Health (UK) until March 2003. I am writing in a personal capacity.
[1] Peto R et al. Smoking, smoking cessation, and lung cancer in the UK since 1950: combination of national statistics with two case-control studies. BMJ 2000; 321: 323-329.
[2] Advisory Council on the Misuse of Drugs. The classification of cannabis under the Misuse of Drugs Act 1971, (UK Government) Home Office, March 2002 (5.1).
Competing interests: None declared
Last edited by John (Gold) on 16 Mar 2009, 05:28, edited 2 times in total.
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Golddabler1
Joined: 18 Dec 2008, 23:59

03 May 2003, 07:45 #2

Hi john
There are several type of drugs related to cannabis which involve roll ups with tobacco,i,ve witnessed people getting hooked on nicotine inadvertantly,ie they thought they were smoking a so called recreational drug only to find they had a desire for cigarettes.Everybody is trying to legalise cannabis but forgetting that cigarettes are tools in that process and i would guess that tobacco plus cannabis extracts mixed together probably have more chemicals than a cigarette its self.
Rickdabler 1 month 3 weeks 2 days 21hrs 40 mins happily nicotine free.Image
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OBob Gold
Joined: 18 Dec 2008, 23:58

03 May 2003, 08:00 #3

More on the subject here:

Nicotine Vs. Marijuana

Image
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FreedomNicotine
Joined: 06 Dec 2008, 16:58

17 Feb 2009, 12:17 #4

Message 1 of 28 in Discussion
From: duncan (Original Message)
Sent: 4/29/2001 11:51 AM

Hey My Freedom Mates -
Does anyone know where Marijuana fits into the scheme of things with Freedom - is this topic taboo - I am only interested - In bringing up this topic .... I hope I have'nt offended anyone - that's the last thing I'd wish for -
I personally don't smoke Marijuana anymore - I used to - however - I'm sure there's a few of us here who have thought about this issue or have come across it as a Pot smoker - What are the physical similarities to normal smoking in terms of health implications etc ? ... anyone know ?
Does Marijuana have nicotine properties ?

Love Duncan

Four weeks, 2 hours, 27 minutes and 14 seconds. 702 cigarettes not smoked, saving $250.11. Life saved: 2 days, 10 hours, 30 minutes.
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FreedomNicotine
Joined: 06 Dec 2008, 16:58

17 Feb 2009, 12:18 #5

Cannabis smoking 'more harmful' than tobacco
14:02 11 November 02
Emma Young - The New Scientist
Smoking pure marijuana is at least as harmful to lungs as smoking tobacco, a report from the British Lung Foundation concludes. And in some key ways, it may be more dangerous.

For example, the BLF's review of previous research highlights that just three marijuana joints a day causes the same damage to the lung's airways as 20 cigarettes, mainly because of the way joints are smoked.

Individually, cannabis and tobacco produce the same constituents and quantities of chemicals known to be toxic to respiratory tissue, other than nicotine, the report says. But when cannabis and tobacco are smoked together, the health effects are worse.

"These statistics will come as a surprise to many people, especially those who choose to smoke cannabis rather than tobacco in the belief it is safer for them," says Mark Britton, chairman of the BLF. A UK survey conducted earlier in 2002 found that 79 per cent of children believed cannabis to be 'safe'.


Deep breath


A key finding highlighted by the review of 90 published papers is that the amount of smoke taken into the lungs is two thirds larger if cannabis is being smoked. The smoke is also taken one third deeper into the lungs - and that smoke is held an average of four times longer before being exhaled.

"You inhale deeper and hold your breath with the smoke for longer before exhaling. This results in more poisonous carbon dioxide and tar entering into the lungs," says Helena Shovelton, BLF's chief executive.

Other points in the report include:

• Tar from cannabis cigarettes contains up to 50 per cent higher concentrations of carcinogens benzathracenes and benzpyrenes than tobacco smoke

• THC, the primary psychoactive ingredient of cannabis, decreases the function of immune system cells that help protect the lungs from infection

• The average cannabis cigarette smoked in the 1960s contained about 10 milligrams of tetrahydrocanabinol (THC), the primary psychoactive ingredient. Today, it may contain 150 mg.

"This means that the modern cannabis smoker may be exposed to greater doses of THC than in the 1960s or 1970s," says the report. "This in turn means that studies investigating the long-term effects of smoking cannabis have to be interpreted cautiously."


Mouth spray


Cannabis is the most widely consumed illegal drug in the UK. In 2000, almost 45 per cent of 16 to 29 year olds in the UK said they had used cannabis at some point.

"We are not making any policy recommendations. The aim of this report is to try to inform the public that if you do choose to smoke cannabis, be aware of the health risks," says a BLF spokeswoman.

Cannabis-based medicines could be prescribed for medical use in the UK as early as 2003, following the recent success of final-stage trials. But medicinal cannabis is supplied through a mouth spray or in tablet form.

"We have always been keen to find additional ways of administering cannabis as a medicine," says Nina Booth-Clibborn of the UK's Medicinal Cannabis Research Foundation. "It did seem that smoking would not be the best way."

Lyndon Pugh, editor of pro-cannabis magazine CC Newz, is not impressed by the report: "These allegations have been made before countless times. Lot of things are dangerous, like driving."
14:02 11 November 02
Return to news story


© Copyright Reed Business Information Ltd.
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FreedomNicotine
Joined: 06 Dec 2008, 16:58

17 Feb 2009, 12:20 #6

From: Toast (GOLD!!) Sent: 2/1/2003 5:20 PM
From: http://www.pbs.org/wgbh/p...ws/dope/body/effects.html


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MEMORY/PERCEPTION/BEHAVIOR
1. Attention, memory and learning are impaired among heavy marijuana users, even after users discontinued its use for at least 24 hours. Heavy marijuana use is associated with residual neuropsychological effects even after a day of supervised abstinence from the drug. Heavy users displayed significantly greater impairment than light users on attention/executive functions, as evidenced particularly by greater preservations on card sorting and reduced learning of word lists. These differences remained after controlling for potential confounding variables, such as estimated levels of premorbid cognitive functioning, and for use of alcohol and other substances in the two groups. However, the question remains open as to whether this impairment is due to a residue of drug in the brain, a withdrawal effect from the drug, or a frank neurotoxic effect of the drug. ("The Residual Cognitive Effects of Heavy Marijuana Use in College Students," Pope, HG Jr., Yurgelun-Todd, D., Biological Psychiatry Laboratory, McLean Hospital, Belmont, MA, JAMA February 21, 1996.)

2. Impaired memory for recent events, difficulty concentrating, dreamlike states, impaired motor coordination, impaired driving and other psychomotor skills, slowed reaction time, impaired goal-directed mental activity, and altered peripheral vision are common associated effects. (Adams and Martin 1996; Fehr and Kalant 1983; Hollister 1988a; Institute of Medicine 1982; Tart 1971)

3. A roadside study of reckless drivers who were not impaired by alcohol, showed that 45% of these drivers tested positive for marijuana. (Dr. Dan Brookoff, published in the New England Journal of Medicine)

4. Marijuana smoking affects the brain and leads to impaired short-term memory, perception, judgment and motor skills. (Marijuana Facts: Parents Need to Know, National Institute on Drug Abuse )

5. In a survey of 150 marijuana using students, 59% surveyed report they sometimes forget what a conversation is about before it has ended. 41% report if they read while stoned they remembered less of what they had read hours later. (Dr. Richard Schwartz, Vienna Pediatric Associates in Psychiatric Annals as reported in NIDA Capsules)
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6. Marijuana activates the same pleasure centers in the brain that are targeted by heroin, cocaine and alcohol. (Dr. Gaetano Di Chiara, University of Caligari, Italy)

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7. Physiological effects of marijuana include an alteration of heart rate. Use of marijuana may result in intense anxiety, panic attacks or paranoia. (National Institute of Drug Abuse)

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8. The daily use of 1 to 3 marijuana joints appears to produce approximately the same lung damage and potential cancer risk as smoking 5 times as many cigarettes. (UCLA) The study results suggest that the way smokers inhale marijuana, in addition to its chemical composition, increases the adverse physical effects. The same lung cancer risks associated with tobacco also apply to marijuana users, even though they smoke far less. (reported in NIDA Capsules)

9. Benzopyrene is the chemical in tobacco that causes lung cancer. An average marijuana cigarette contains nearly 50% more benzopyrene than a tobacco cigarette. An average marijuana cigarette contains 30 nanograms of this carcinogen compared to 21 nanograms in an average tobacco cigarette (Marijuana and Health, National Academy of Sciences, Institute of Medicine Report, 1982) Benzopyrene suppresses a gene that controls growth of cells. When this gene is damaged the body becomes more susceptible to cancer. This gene is related to half of all human cancers and as many as 70% of lung cancers.

10. Marijuana users may have many of the same respiratory problems that tobacco smokers have, such as chronic bronchitis and inflamed sinuses. (Marijuana Facts: Parents Need to Know, National Institute on Drug Abuse )

11. Marijuana smokers, when compared to non marijuana smokers, have more respiratory illness. (Polen et al. 1993).

12. Marijuana smoke produces airway injury, acute and chronic bronchitis, lung inflammation, and decreased pulmonary defenses against infection. Smoking one marijuana cigarette leads to air deposition of four times as much cancer-causing tar as does tobacco smoke (Dr. D. Tashkin, Western Journal of Medicine)

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13. Heavy marijuana use can affect hormones in both males and females. Heavy doses of the drugs may delay the onset of puberty in young men. Marijuana also can have adverse effects on sperm production. Among women, regular marijuana use can disrupt the normal monthly menstrual cycle and inhibit the discharge of eggs from the ovaries. (Marijuana Facts: Parents Need to Know, National Institute on Drug Abuse)

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14. An "amotivational syndrome" can develop in heavy, chronic marijuana users. It is characterized by decreased drive and ambition, shortened attention span, poor judgment, high distractibility, impaired communication skills, and diminished effectiveness in interpersonal situations. (National Institute of Drug Abuse)

15. Adults who smoked marijuana daily believed it helped them function better, improved self-awareness and improved relationships with others. However, researchers found that users were more willing to tolerate problems, suggesting that the drug served as a buffer for those who would rather avoid confronting problems than make changes that might increase their satisfaction with life. The study indicated that these subjects used marijuana to avoid dealing with their difficulties and the avoidance inevitably made their problems worse. Although users believed the drug enhanced understanding of themselves, it actually served as a barrier against self-awareness. (case studies by research team from Center for Psychosocial Studies in New York.)

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FreedomNicotine
Joined: 06 Dec 2008, 16:58

17 Feb 2009, 12:20 #7

From: Toast (GOLD!!) Sent: 2/1/2003 5:21 PM
Marijuana v.s. Tobacco smoke compositions
From: Institute of Medicine, Marijuana and Health, Washington,D.C.
National Academy Press, 1988
"The smoke from any burning plant contains hundreds of chemicals that may have biological effects . . ."

"Cannabis smoke is similar to tobacco smoke in that it is a mixture of very small particles and a gas-vapor phase. Both the particulate and vapor phases contain many identified and probably some still unidentified constituents that, based on clinical experience with tobacco smoke, must be assumed to be potentially harmful. The amounts of some materials in tobacco cigarete and marijuana cigarette smoke are compared in Table 3. Toxic substances, such as carbon monoxide, hydrogen cyanide, and nitrosamines occur in similar concentrations in tobacco and marijuana smoke; so do the amounts of particulate material known collectively as "tars"." (pg 15)

[Editorial comment by Jon Gettman: The cancer risk in the most part comes from the smoke, not from the cannabinoids. This is an artifact of the delivery system, not the drug (it comes from burning the plant material, not the cannabinoids). As many of you know, THC has a lower vaporization temperature than the plant material it is contained in, and as Lester Grinspoos and others often point out, a vaporizer could be designed to vaporize the cannabinoids without burning the plant material and producing smoke filled with tars and other particulate matter. Also, the composition of the plant and its smoke has been known since the 1970's, and this didn't prevent Leo Hollister and the National Academy of Sciences from noting that marijuana has therapeutic potential.]

Table 3 : Marijuana and Tobacco Reference Cigarette Analysis of Mainstream Smoke (pg 17)

Strange Abbr: mcg: microgram C? : known Carcinogen (X means yes)
[size=80]A.Cigarettes[/size] [size=80]Units[/size] [size=80]Marijuana[/size] [size=80]Tobacco[/size]
(85mm) (85mm)
Average Weight (mg) 1115 1110
Mositure (%) 10.3 11.1
Pressure Drop cm 14.7 7.2
Static Burning rate mg/s 0.88 0.80
Puff Number 10.7 11.1
[size=80]B.Mainstream Smoke[/size] [size=80]I. Gas Phase[/size] [size=80]Units[/size] [size=80]Marijuana[/size] [size=80]Tobacco[/size]
Carbon Monoxide % 3.99 4.58
mg 17.6 20.2
Carbon Dioxide % 8.27 9.38
mg 57.3 65.0
Ammonia mcg 228 199
HCN mcg 532 498
Cyanogen (CN)2 mcg 19 20
Isoprene mcg 83 310
Acetaldehyde mcg 1200 980
Acetone mcg 443 578
Acrolein mcg 92 85
Acetonitrilebenzene mcg 132 123
Benzene mcg 76 67
Toluene mcg 112 108
Vinyl chloride ng 5.4 12.4
Dimethylnitrosamine ng 75 84
Methylethylnitrosamine ng 27 30
pH, third puff 6.56 6.14
fifth puff 6.57 6.15
seventh puff 6.58 6.14
ninth puff 6.56 6.10
tenth puff 6.58 6.02
[size=80]II. Particulate phase[/size] [size=80]Units[/size] [size=80]Marijuana[/size] [size=80]Tobacco[/size]
Tl particulate - dry mg 22.7 39.0
Phenol mcg 76.8 138.5
o-Cresol mcg 17.9 24
m- and p-Cresol mcg 54.4 65
Dimethylphenol mcg 6.8 14.4
Catechol mcg 188 328
Cannbidiol mcg 190
D9 THC mcg 820
Cannabinol mcg 400
Nicotine mcg 2850
N-Nitrosonornicotine ng 390
Naphthalene mcg 3.0 1.2
1-Methylnaphthalene mcg 6.1 3.65
2-Methylnaphthalese mcg 3.6 1.4
Benz(a)anthracene ng 75 43
Benzo(a)pyrene ng 31 21.1
Sources cited by the Institute of Medicine:

Hofmann, D., Brunnemann, K.D.,Gori,G.B. and Wynder, E.L. On the carcinogenicity of marijuana smoke, pp 63-81. In Runeckles, V.C. (ed) Recent Advances in Phytochemistry New York: Plenum Publishing Corp., 1975.

Hoffmann, D., Patrianakos, C., Brunneman, K.D., et al. Chromatographic determination of vinyl chloride in tobacco smoke. Anal Chem 48:47-50, 1976.

Brunnemann,K.D., Lee, H.C., and Hoffmann, D. Chemical studies on tobacco smoke. XLVII. On the quantitative analysis of catechols and their reduction. Anal. Lett. 9:939-955, 1976.

Brunnemann, K.D., Yu, L., and Hoffmann, D. Chemical Studies on tobacco somke. XLIX. Gas chromotographic determination of hydrogen cyanide and cynogen in tobacco smoke. J Anal. Toxicol. 1:38-42, 1977.

From: http://www.erowid.org/pla...abis/cannabis_info3.shtml

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FreedomNicotine
Joined: 06 Dec 2008, 16:58

17 Feb 2009, 12:21 #8

From: Joel. Sent: 2/1/2003 5:42 PM
Below is a response that I wrote back over two years ago to a member who asked about the consequences of her boyfriend smoking marijuana after he had quit smoking tobacco cigarettes. The message is still as pertinent today as it was back then. We are dealing with nicotine addiction here at Freedom, even more than we are dealing with dangers associated with smoking. It is true that marijuana and tobacco smoke have many similar chemicals and thus many similar dangers. But there is one significant difference and that is the presence of nicotine. Tobacco has nicotine in it and marijuana does not. Marijuana cannot cause a person to relapse on nicotine. But with that being said, the message below should not be ignored or overlooked either. I always want the message below to be read by anyone reading this thread.


In response to the implication of my boyfriend who has quit smoking cigarettes but still smoking marijuana:

First, he should not in any way shape or form substitute one drug for another, whether it is pot, alcohol, coffee, tranquilizers, stimulants, or whatever. The concept of substitution is a crutch and a crutch is going to have its own inherent problems.

OK, so what about smoking pot as its own issue. I always tell my groups that quitting smoking, or I guess for clarity sake here, getting off nicotine requires one thing only, that is getting off nicotine. Everything a person does as a smoker they can do without smoking. I mean this when I say it. Everything. Things that are good for them and they enjoy, they can do after they quit smoking. Things that are good for them and they don't enjoy they can do after they quit smoking. Things that are not good for them and they enjoy they can do without smoking. And things that are not good for them and the do not enjoy they can do too. Basically the message I want everyone to understand is anything they could do as a smoker, they can now do as an ex-smoker. Anything.

I am not trying to give an endorsement to an illegal product, one that has many of the same chemicals at tobacco smoke and so have some of the same health risks. But while the chemical structure of the two are similar, marijuana actually having higher concentrations of some of the poisons than even tobacco smoke, there is one big difference between the two. It is the active drug that is not shared. Tobacco contains nicotine, marijuana contains Tetrahyrdocannibinol (THC) (the spelling might be wrong). So can marijuana be smoked without relapsing to cigarettes, yes. Should it be used as a substitution, definately not. If you were not using it before there is no way it should be incorporated into your life now.

If you were using it before, well for legal and for some medical risks, you should not have been. For those same reasons you should stop now. But as far as it causing a nicotine relapse, it won't, at least no more than alcohol will. What I mean by that is alcohol can lower a persons resolve and make them more vulnerable to relapse. Same with marijuana, maybe even more so. But the actual act of smoking marijuana is not going to cause a relapse to nicotine, only administration to nicotine can accomplish that feat.

I wrote to someone yesterday who wasn't sure of us at Freedom yet that we have no hidden agendas here. I meant that when I wrote it. We are not trying to force any changes in a persons life. The only area we are working on as our stated objective is breaking the nicotine addiction. This is why I am trying to make it clear that other activities can be done, but again, I am not saying it should, that it is safe or that it is right. On many fronts marijuana use is dangerous, from legal, and medical issues, but it is up to each and every individual here to decide what is right or wrong for them.

Hope this answers your friends questions. I am going to bring up the article on crutch replacement now for further elaboration of the substitution risk.

To stay in control of your nicotine addiction, which is all we are asking of everyone here, remember as for tobacco cigarettes, never take another puff!

Joel
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FreedomNicotine
Joined: 06 Dec 2008, 16:58

17 Feb 2009, 12:22 #9

From: ImageImageMsArmstrongKIS Sent: 4/18/2003 12:46 PM
I started using tobacco for many reasons, but one of my very earliest quit attempts (after smoking for about a year) was ruined by smoking pot with a bunch of friends. They all seemed to think that smoking cigarettes after smoking marijuana was the obvious thing to do.

Too bad! I won't smoke pot anymore because it feels horrible on my lungs and I feel sick for the whole day after. Can't believe I used to put that tar into them on a daily basis!

Alex
2 months 5 days
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FreedomNicotine
Joined: 06 Dec 2008, 16:58

17 Feb 2009, 12:24 #10

From: Joanne - Gold Sent: 4/29/2001 8:28 PM
Hi DuncanImage holy moly...your stats are awesome...good for you. Congratulations!

I have an old post here that Joel wrote on Nicotine and Marijuana use during smoking cessation. Hope this helps. Have a great day....keep up the good work.

Love ya...Joanne


From: Joel (Mgr) Sent: 1/23/2001 8:19 AM 2 of 2
Hello Pookie:

First, he should not in any way shape or form substitute one drug for another, whether it is pot, alcohol, coffee, tranquilizers, stimulants, or whatever. The concept of substitution is a crutch and a crutch is going to have its own inherent problems.

OK, so what about smoking pot as its own issue. I always tell my groups that quitting smoking, or I guess for clarity sake here, getting off nicotine requires one thing only, that is getting off nicotine. Everything a person does as a smoker they can do without smoking. I mean this when I say it. Everything. Things that are good for them and they enjoy, they can do after they quit smoking. Things that are good for them and they don't enjoy they can do after they quit smoking. Things that are not good for them and they enjoy they can do without smoking. And things that are not good for them and the do not enjoy they can do too. Basically the message I want everyone to understand is anything they could do as a smoker, they can now do as an ex-smoker. Anything.

I am not trying to give an endorsement to an illegal product, one that has many of the same chemicals at tobacco smoke and so have some of the same health risks. But while the chemical structure of the two are similar, marijuana actually having higher concentrations of some of the poisons than even tobacco smoke, there is one big difference between the two. It is the active drug that is not shared. Tobacco contains nicotine, marijuana contains Tetrahyrdocannibinol (THC) (the spelling might be wrong). So can marijuana be smoked without relapsing to cigarettes, yes. Should it be used as a substitution, definately not. If you were not using it before there is no way it should be incorporated into your life now.

If you were using it before, well for legal and for some medical risks, you should not have been. For those same reasons you should stop now. But as far as it causing a nicotine relapse, it won't, at least no more than alcohol will. What I mean by that is alcohol can lower a persons resolve and make them more vulnerable to relapse. Same with marijuana, maybe even more so. But the actual act of smoking marijuana is not going to cause a relapse to nicotine, only administration to nicotine can accomplish that feat.

I wrote to someone yesterday who wasn't sure of us at Freedom yet that we have no hidden agendas here. I meant that when I wrote it. We are not trying to force any changes in a persons life. The only area we are working on as our stated objective is breaking the nicotine addiction. This is why I am trying to make it clear that other activities can be done, but again, I am not saying it should, that it is safe or that it is right. On many fronts marijuana use is dangerous, from legal, and medical issues, but it is up to each and every individual here to decide what is right or wrong for them.

Hope this answers your friends questions. I am going to bring up the article on crutch replacement now for further elaboration of the substitution risk.

To stay in control of your nicotine addiction, which is all we are asking of everyone here, remember as for tobacco cigarettes, never take another puff!

Joel
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