Pubdate: Wed, 15 Feb 2012
Source: Charleston Gazette (WV)
Copyright: 2012 Charleston Gazette
Author: James D. Felsen


CHARLESTON, W.Va. -- It is possible that the hospital doctors and
nurses who care for you in the future will be tobacco free but stoned,
if things get any more squirrelly.

Let us put aside parsing legal terms and requirements contained within
various federal and state laws and regulations, including the
Americans with Disability Act and analyze the situation from a common
sense perspective.

 From a medical standpoint, with a few rare exceptions, almost all
physicians would advise their patients and employers that smoking
tobacco and marijuana has negative health and safety consequences for
the smoker and those in the smoker's close proximity. From a public
policy perspective, "Drug Free Workplace" and "Clean Air" statutes and
ordinances have supported this advice for several decades.

A widely publicized Jan. 10 article in the Journal of the American
Medical Association by researchers at UC San Francisco assert that
smoking marijuana (at least occasionally) is not detrimental to lung
health, as is smoking cigarettes. They are not sure why, listing
several possible explanations, including that THC (the active
substance in marijuana) may have an anti-inflammatory, protective effect.

Although the authors caution that the public should not conclude that
smoking marijuana has health benefits, it is likely that is precisely
how it will be touted by advocates of legalization. A fall 2011 Gallup
poll revealed that 50 percent of Americans favor legalizing marijuana,
up from 12 percent in 1969. A recent National Institute on Drug Abuse
survey reveals that smoking marijuana has reached an all-time level in
high school students, while smoking cigarettes and drinking alcohol
has declined. About 20 states now have legalized "medical marijuana"
and the number is growing, some suggesting such legalization
contributes to the increasing use within the high school population.

Meanwhile, anti-smoking advocates have castigated state legislators
for siphoning off funds from quit-smoking programs, even though some
programs that employ nicotine replacement through patches and gum have
been controversial for years. Several recent studies publicized in
major newspapers suggest such costly programs may have a relapse rate
equal to those observed in individuals who use no aids and question
the prudence of continued funding.

A recent, USA Today article notes that an increasing number of
employers, especially in the health industry, are refusing to hire
cigarette smokers and a spokesperson for the U.S. Equal Employment
Opportunity Commission has defended this as legal since smokers are
not a protected class.

Availability of "medical marijuana" is defended on the basis that THC
(especially when smoked) may have positive health benefits for those
suffering from cancer, HIV, chemotherapy, and a list of other conditions.

However, nicotine, the active ingredient in tobacco smoke, also has
long been known to have a positive effect in Parkinson disease tremors
and recent reports in The Washington Post and Los Angeles Times, among
others, reveal it may have health benefits in memory loss and
cognitive impairments associated with Alzheimer's disease and other

How long will it be until individuals who are prescribed "medical
marijuana" by a physician challenge workplace "drug free" and "clean
air" laws under the "reasonable accommodation" provisions of the ADA?
They will contend they should be free to smoke at work as long as
their performance is satisfactory, especially since the second-hand
THC smoke they generate may have a positive health effect upon them
and other workers. Meanwhile, the sober cigarette smoker, willing to
forego smoking in the workplace, will remain unemployed. Squirrelly!

Felsen, of Great Cacapon, is a retired public health physician.
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