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Research Shows Emphysema More Common in Marijuana Smokers Than Cigarette Smokers

A new study has revealed that marijuana smokers have a higher rate of emphysema and airway diseases compared to cigarette smokers.

Researchers have found marijuana smokers have a higher rate of emphysema and airway diseases compared to cigarette smokers. The findings, from the University of Ottawa and The Ottawa Hospital, will be published today (November 15) in the journal Radiology.

In the study, the chest CT examinations of 56 marijuana smokers, 57 non-smokers, and 33 tobacco-only smokers between 2005 and 2020 were analyzed. The investigators determined higher rates of paraseptal emphysema (PSE) and airway inflammatory changes, such as bronchiectasis, bronchial wall thickening, and mucoid impaction, in the marijuana smokers.

Airway Changes in Marijuana and Tobacco Smoker

Airway changes in a 66-year-old male marijuana and tobacco smoker. Contrast-enhanced (A) axial and (B) coronal CT images show cylindrical bronchiectasis and bronchial wall thickening (arrowheads) in multiple lung lobes bilaterally in a background of paraseptal (arrows) and centrilobular emphysema. Credit: Radiological Society of North America

Giselle Revah is a radiologist and Assistant Professor in the Faculty of Medicine who was searching for answers on the effect of marijuana on the lungs and its health implications. This was especially important, as there was little information available in the current literature since marijuana only became legal in Canada in 2018.

“I can tell if someone is a heavy or a long-time cigarette smoker when I look at a CT scan. With marijuana being the second most inhaled substance after tobacco, I started wondering: What does marijuana inhalation look like on a CT scan? Would I be able to tell if someone was a marijuana smoker, is it different from cigarette smoke?” says Revah, a radiologist at The Ottawa Hospital, where the research was conducted.

Pulmonary Emphysema in Marijuana and Tobacco Smokers

Pulmonary emphysema in (A, B) marijuana and (C, D) tobacco smokers. (A) Axial and (B) coronal CT images in a 44-year-old male marijuana smoker show paraseptal emphysema (arrowheads) in bilateral upper lobes. (C) Axial and (D) coronal CT images in a 66-year-old female tobacco smoker with centrilobular emphysema represented by areas of centrilobular lucency (arrowheads). Credit: Radiological Society of North America

“What’s unique about this study is that it there hasn’t been anything comparing the imaging findings in tobacco smokers to marijuana smokers before. In fact, there is a lack of imaging research in marijuana, probably because it’s still illegal in many parts of the world, and in many U.S. states, which is why I think we were the first to do a project like this.”

Despite the small sample size, Revah’s findings suggest that marijuana smokers saw additional effects on the lungs above tobacco alone, including more instances of large and small airway diseases.

“We’ve identified an association between marijuana smoking and damage to both the small and the large airways,” she said. “We still need more research before we can affect policy change. We need larger, more robust prospective studies with more patients to confirm it.”

Reference: “Chest CT Findings in Marijuana Smokers” by Luke Murtha, Paul Sathiadoss, Jean-Paul Salameh, Matthew D. F. Mcinnes and Giselle Revah, 15 November 2022, Radiology.
DOI: 10.1148/radiol.212611

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