Pubdate: Sat, 20 Sep 2003
Source: British Medical Journal, The (UK)
Issue: 2003; Issue 7416; 327:635-636
Copyright: 2003 The BMJ
Contact:  http://www.bmj.com/
Details: http://www.mapinc.org/media/60
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COMPARING CANNABIS WITH TOBACCO - AGAIN

Link Between Cannabis And Death Still Not Established

Although the use of cannabis is not harmless, its link with death is still 
not established, argues a senior researcher in this week's BMJ.

Two large studies reported no increase in death associated with the use of 
cannabis. Even diseases that might be related to long term cannabis use are 
unlikely to have a sizeable public health impact because, unlike users of 
tobacco and alcohol, most people who try cannabis quit relatively early in 
their adult lives, writes the author.

Exposure to smoke is generally much lower in cannabis than in tobacco 
cigarette smokers, even taking into account the larger exposure per puff. 
Existing studies do not support a link between the use of cannabis and 
heart disease, the leading cause of death in many Western countries, he 
adds. Furthermore, cannabis does not contain nicotine, a chemical contained 
in tobacco that is addicting and contributes to the risk of heart disease.

However, two caveats must be noted regarding available data, warns the 
author. Firstly, the studies to date have not followed cannabis smokers 
into later adult life so it might be too early to detect an increase risk 
of chronic diseases that are potentially associated with the use of cannabis.

Secondly, the low rate of regular cannabis use and the high rate of 
discontinuation during young adulthood may reflect the illegality and 
social disapproval of the use of cannabis. This means that we cannot assume 
that smoking cannabis would continue to have the same small impact on 
mortality if its use were to be decriminalised or legalised.

While the use of cannabis is not harmless, our current knowledge does not 
support the assertion that it has an adverse impact on death rates, says 
the author. Common sense should dictate measures to minimise adverse 
effects. These include discouraging use by teenagers, not using when 
driving or operating heavy machinery, not using excessively, and cautioning 
people with known coronary heart disease.
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MAP posted-by: Beth