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Any risks smoking pot and taking the pill?
October 24, 2008 8:59 PM   Subscribe

Does smoking marijuana carry the same risks as smoking tobacco while taking birth control pills?

The fine print is very explicit about the risks of smoking cigarettes but no mention of smoking pot. Not much luck searching around the internet either. If helpful, Tri-Sprintec is the brand.
posted by Satapher to Health & Fitness (19 answers total)
 
As far as I know, pot does not cause the same cardiovascular problems as cigarettes do. That's where'd you have to be concerned. Of course, IANAD, but I am a toker and former b/c pill user and cigarette smoker. My doctors, in light of my migraines, advised me to quit smoking cigarettes, but seemed not to care so much about my pot habits- at least in those terms.
posted by sunshinesky at 9:09 PM on October 24, 2008


I think the concern is nicotine. There is no nicotine in marijuana.
posted by Class Goat at 9:14 PM on October 24, 2008


I'd say no. I'm of the understanding that the issue is nicotine's cardiovascular effects. Marijuana doesn't have those effects.
posted by Netzapper at 9:56 PM on October 24, 2008


Just anecdotal evidence, but I have a blood clotting problem (that is, it is "sticky" and forms clots) and also suffer from Raynaud's Syndrome, which causes the blood vessels to constrict. Back when I still smoked cigarettes, I noticed that occasionally a few puffs would make me dizzy enough that I had to sit down or else topple over. My rheumatologist told me that nicotine was the culprit (and emphasized that that was just one more reason to quit, which I eventually did.) Marijuana never had a similar effect. (Note the past tense, Internet detectives or Mom or my doctor....)
posted by Oriole Adams at 1:15 AM on October 25, 2008


There's very likely never been a study of the effect you're talking about, so no definitive answer to that question exists. Numerous studies have shown that pot is not physically harmful in any way, if consumed in moderation. I remember one study a while back saying how pot could be lethal--if you smoked 20 joints a day, or some such ridiculous total.
posted by zardoz at 4:05 AM on October 25, 2008


There's very likely never been a study of the effect you're talking about, so no definitive answer to that question exists. Numerous studies have shown that pot is not physically harmful in any way, if consumed in moderation. I remember one study a while back saying how pot could be lethal--if you smoked 20 joints a day, or some such ridiculous total.

While running the risk of a bit of a derail, this is not, strictly speaking, true in terms of lung cancer. Basically, putting anything into your lungs that your body cannot clear puts you at a higher risk for lung cancer. Note, for example, the big pullback in inhale-able insulin from the drug companies -- rumor had it there was a slight increase in the people getting lung cancer, and they got out of there quick, despite the fact that any product that lets diabetics inhale insulin rather than inject would make whomever developed it really, really rich.

Yes, this includes constantly grilling over charcoal, sitting next to giant laser printers all day, and smoking joints.
posted by Comrade_robot at 6:09 AM on October 25, 2008 [2 favorites]


I'm thinking the only reason it would cause any problems would be if you were smoking a spliff with tobacco in.
posted by jhighmore at 6:25 AM on October 25, 2008


Smoking anything has negative health effects for your lungs, so the person who said that smoking pot in moderation has no negative health effects is incorrect.

Specifically in regards to blood clotting while on HBC, though, nicotine is the concern, not the smoke itself.
posted by fructose at 9:19 AM on October 25, 2008


From what I understand, you can limit potential cannabis smoke impact by using a vaporiser, which limits the combustibles that transfer into your system without also removing the active properties of the smoke....but that's neither here nor there.

I've no real data on your actual question, although those putting forth the nicotine theory seem to have a point. I know birth control pills come with a risk of blood clots, so it seems like anything that could affect blood flow in further unpredictable fashions would be a bad idea to add in.
posted by batmonkey at 9:52 AM on October 25, 2008


While running the risk of a bit of a derail, this is not, strictly speaking, true in terms of lung cancer. Basically, putting anything into your lungs that your body cannot clear puts you at a higher risk for lung cancer.

Strictly speaking, your generalization is wrong. Just because your body doesn't "clear" something doesn't mean it has the potential to the cause intracellular events at the nuclear/DNA level that would lead to the aberrant cell division which is a hallmark of dysplasia and cancer. Many chemicals have the potential to be either inert to begin with or appropriately sequestered but not "cleared" per se by the body's defenses.

While it is currently believed that tobacco increases thrombotic risk via a number of mechanisms including hyperfibrinogenemia with chronic use, elevated catecholamines, augmented platelet aggregation, and other effects, it is not entirely clear which components of tobacco are at play, and while nicotine is one factor, it is unlikely to be the only factor leading to hypercoagulability.

There is much less available in the medical literature regarding marijuana, but case reports have been published potentially linking marijuana to strokes and heart attacks even in young patients. While cause for some concern, this is not high level evidence and is to be taken with perhaps a grain of salt.

The short answer to your question is maybe but we really don't know with any certainty.
posted by drpynchon at 9:57 AM on October 25, 2008 [1 favorite]


Basically, putting anything into your lungs that your body cannot clear puts you at a higher risk for lung cancer.

But presumably if that was a significantly bigger risk than the general population, we'd have epidemiological studies that demonstrate it -- particularly in light of the phenomenal amounts of money that the US government has spent every year to try and prove marijuana-related health risks.

I'm not aware of any such studies. But here's a couple of links that summarize what *is* currently known on the issue:

http://cebp.aacrjournals.org/cgi/content/abstract/15/10/1829
http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=16054989&cmd=showdetailview&indexed=google
posted by PeterMcDermott at 10:31 AM on October 25, 2008


fructose wrote: Smoking anything has negative health effects for your lungs, so the person who said that smoking pot in moderation has no negative health effects is incorrect.

Except, you know, the multiple studies on the subject that failed to show a link to cancer in even long term heavy marijuana smokers.

It does have a demonstrable effect on memory that goes away after you stop, but not for a few months if you were a heavy smoker, and long term heavy smoking would seem to put you at risk for emphysema, but I haven't seen any studies on that.

Of course, part of the difference may be that the usual rate of consumption for a cigarette smoker is around 20 cigarettes a day, while even a habitual marijuana smoker usually smokes 5 or fewer a day, although even heavier use hasn't been shown to cause serious health effects, I find it harder to believe that's not just from the dearth of studies.
posted by wierdo at 12:10 PM on October 25, 2008 [1 favorite]


I should have said "...heavy marijuana smokers who were not also tobacco users"
posted by wierdo at 12:12 PM on October 25, 2008


Strictly speaking, your generalization is wrong. Just because your body doesn't "clear" something doesn't mean it has the potential to the cause intracellular events at the nuclear/DNA level that would lead to the aberrant cell division which is a hallmark of dysplasia and cancer. Many chemicals have the potential to be either inert to begin with or appropriately sequestered but not "cleared" per se by the body's defenses.

OK, well, maybe it was a bit of a wide generalization based on something someone told me about why we weren't going to be working on inhalables. I do, however, find literature suggesting higher incidences of lung cancer with exposure to wood smoke (Delgado et al, Lung Cancer Pathogenesis Associated With Wood Smoke Exposure, Chest. 2005;128:124-131) and coal smoke (Mumford et al, Human exposure and dosimetry of polycyclic aromatic hydrocarbons in urine from Xuan Wei, China with high lung cancer mortality associated with exposure to unvented coal smoke, Carcinogenesis, Vol. 16, No 12, 3031-3036).

There are studies on cannabis smoking and lung cancer -- since cannabis is illegal in the United States, I do not think you are going to get federal funding to do any studies on its effects on humans. A recent article in the European respiratory journal (Brambilla, Colonna Eur Respir J 2008; 31:227-228) states:

Although some may comment on the methodology of the study, the conclusions are robust; cannabis smoking increases the risk of developing a lung cancer independently of an eventual associated tobacco exposure. The study confirms preliminary conclusions 7 using a population-based, case–control study that avoids the bias of hospital-based studies. As in the tobacco story, we are now confronted with evidence and have to switch from a statistical association to the biological indication that some components of cannabis itself or cannabis smoke are real lung carcinogens, able to induce oncogenic molecular changes in the respiratory tract. The prudence principle should be sufficient to convince everybody that lung cancer has to be added to the list of secondary effects of cannabis smoking, along with asthma and chronic obstructive pulmonary disease 8–11. Again, as in the tobacco story, the delay between smoking and death from cancer strongly attenuates an individual’s perception of risk, whereas the political opinion is that cannabis consumption is lethal. It is easier to understand that driving a car under the influence of several "joints" is dangerous, particularly for the innocent individuals who may become inadvertently involved 12. In this case, it is easy to convince politicians of the risk, but individual attitudes will probably take many years to educate 13. The biological effects of cannabis components have been studied particularly for their psychotropic effects, and may be used to alleviate the consequences of advanced disease 14. However, the studies on molecular alteration risk are sparse. The first report 14 was rather optimistic since the conclusions were that cannabinoids could be considered as anti-oncogenic molecules, which is true for some components of cannabis. A further study showed that, on the contrary, cannabis smoke and some main components of cannabis smoke clearly induce oncogenic changes in cell lines, as well as in bronchial biopsies 15. The case–control study by Aldington et al. 6 provides a quantification of the effect of cannabis smoking: the increased risk for each joint-yr of cannabis smoking was similar to that for each pack-yr of cigarettes. In other words, the risk of lung cancer increased by 8% for each joint-yr of cannabis exposure after adjustment for confounding variables, including tobacco smoking.
posted by Comrade_robot at 1:26 PM on October 25, 2008


(derail)
In the study referenced above that looked at lung cancer patients and how many of them smoked marijuana, they used 60 lung cancer patients and 200 controls. That is a very small sample size, and that's one of the "concerns about methodology" that the quote references. There are also marijuana studies going on in the US, particularly in states where medical marijuana is legal. It doesn't necessarily take federal funding to do a study since there are many private health centers, universities and drug companies. A study in California looked at 1200 cancer patients and found no link to marijuana use.
posted by oneirodynia at 5:19 PM on October 25, 2008


Well ... the full abstract of the Aldington et al paper referenced above actually says:

ABSTRACT: The aim of the present study was to determine the risk of lung cancer associated with cannabis smoking. A case–control study of lung cancer in adults f55 yrs of age was conducted in eight district health boards in New Zealand. Cases were identified from the New Zealand Cancer Registry and hospital databases. Controls were randomly selected from the electoral roll, with frequency matching to cases in 5-yr age groups and district health boards. Interviewer-administered questionnaires were used to assess possible risk factors, including cannabis use. The relative risk of lung cancer associated with cannabis smoking was estimated by logistic regression. In total, 79 cases of lung cancer and 324 controls were included in the study. The risk of lung cancer increased 8% (95% confidence interval (CI) 2–15) for each joint-yr of cannabis smoking, after adjustment for confounding variables including cigarette smoking, and 7% (95% CI 5–9) for each pack-yr of cigarette smoking, after adjustment for confounding variables including cannabis smoking. The highest tertile of cannabis use was associated with an increased risk of lung cancer (relative risk 5.7 (95% CI 1.5–21.6)), after adjustment for confounding variables including cigarette smoking.


This is not an unusually small sample size for a study with human or animal subjects, and certainly I have seen studies on unrelated topics with a far smaller n.

The Aldington paper also states:

Cannabis smoking may have a greater potential than tobacco smoking to cause lung cancer 1–4. Cannabis smoke is qualitatively similar to tobacco smoke, although it contains up to twice the concentration of the carcinogenic polyaromatic hydrocarbons 1. Cannabis cigarettes are less densely packed than tobacco cigarettes, and tend to be smoked without filters 2 to a smaller butt size 3, leading to higher concentrations of smoke inhaled. Furthermore, smokers of cannabis inhale more deeply and hold their breath for longer 4, facilitating the deposition of the carcinogenic products in the lower respiratory tract. These factors are likely to be responsible for the five-fold greater absorption of carbon monoxide from a cannabis joint, compared with a tobacco cigarette of similar size despite similar carbon monoxide concentrations in the smoke inhaled 4. Several studies have demonstrated pre-cancerous histological 5, 6 and molecular 7 abnormalities in the respiratory tracts of cannabis smokers, and the carcinogenic effects of cannabis smoke have been demonstrated in vitro 8 and in different in vivo animal models 1, 9, 10. Conversely, there is also evidence that delta-9-tetrahydrocannabinol may have anti-carcinogenic effects 11–13.

You might be interested to know that Tashkin says:

The results should not be taken as a blank check to smoke marijuana, Dr. Tashkin said. Tetrahydrocannibinol, the active ingredient in marijuana, is a known immunosuppressant that interferes with the production of prostimulatory cytokines, including gamma interferon. Marijuana smokers might be at increased risk for respiratory infections, but epidemiologic evidence shows mixed results in the development of pneumonia among marijuana smokers, he said.

Dr. Tashkin also points out the limitations of the study:

As a case-control study, it does have limitations, he added. There is the potential of selection bias—60% of the lung cancer cases could not be interviewed because they were not alive, while 80% of controls were alive—and the data were self-reported. In addition, the patients were under age 69, the average age for lung cancer patients, and therefore more likely to have some genetic abnormality that predisposed them to disease. Dr. Tashkin pointed out that the toxic substances in marijuana smoke may affect an individual’s susceptibility to develop lung cancer. People with a genetic predisposition to developing lung cancer should certainly avoid any assault on the lungs, he said.
posted by Comrade_robot at 7:08 PM on October 25, 2008


But are any of these studies using non-paper-based combustion of the product? Like water pipes, simple pipes, or vapourisers?
posted by batmonkey at 12:10 PM on October 26, 2008


Not to my knowledge. Based on what I've heard from the smoking cessation people, I would expect things not based on combustion: nebulizers, brownies, and that sort of thing to be better lung cancer wise. If you're still burning it, you're still making smoke, and ... well. There have been some studies on the effects of non-smoked cannabis, especially in Canada, where it is prescribed as a therapeutic, and those are inconclusive.

I just think it's a little misleading to say that while most of the other kinds of smoke (wood, coal, tobacco, &c.) cause cancer, marijuana smoke is totally harmless and won't do a thing.
posted by Comrade_robot at 1:28 PM on October 26, 2008


I agree.

I'm curious because I've got friends who will swear up and down that cannabis has no lung cancer risk at all, no matter how imbibed, and that seems ludicrous. Carbon is carcinogenic, and burning something causes carbon. Having it (sort of) confirmed for paper-rolled consumption made me wonder if there was more info on the other methods.

Anyway. Thanks for coming back on that!
posted by batmonkey at 3:40 PM on October 27, 2008


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