Marijuana Smoking Research Articles

Epidemiology studies on effects of lithium salts in pregnancy are confounded by the inability to control for other potentially teratogenic factors.

In bipolar women who took lithium during pregnancy, several epidemiology studies have reported small increases in a rare fetal cardiac defect termed Ebstein's anomaly. Behavioral, environmental, and lifestyle-associated risk factors associated with bipolar disorder and health insurance status were determined from an Internet search. The search was conducted from October 1, 2023, through October 14, 2023. The search terms employed included the following: bipolar, bipolar disorder, mood disorders, pregnancy, congenital heart defects, Ebstein's anomaly, diabetes, hypertension, Medicaid, Medicaid patients, alcohol use, cigarette smoking, marijuana, cocaine, methamphetamine, narcotics, nutrition, diet, obesity, body mass index, environment, environmental exposures, poverty, socioeconomic status, divorce, unemployment, and income. No quotes, special fields, truncations, etc., were used in the searches. No filters of any kind were used in the searches. Women who remain on lithium in the United States throughout their pregnancy are likely to be experiencing mania symptoms and/or suicidal ideation refractory to other drugs. Pregnant women administered the highest doses of lithium salts would be expected to have been insufficiently responsive to lower doses. Any small increases in the retrospectively determined risk of fetal cardiac anomalies in bipolar women taking lithium salts cannot be disentangled from potential developmental effects resulting from very high rates of cigarette smoking, poor diet, alcohol abuse, ingestion of illegal drugs like cocaine or opioids, marijuana smoking, obesity, and poverty. The small risks in fetal cardiac abnormalities reported in the epidemiology literature do not establish a causal association for lithium salts and Ebstein's anomaly.

Drug driving: a secondary analysis of factors associated with driving under the influence of cannabis in Jamaica

ObjectivesTo determine cannabis use patterns, the predictive sociodemographic correlates of driving under the influence of cannabis (DUIC) and the association between risk perception and cannabis dependence among vehicle drivers in...

External hair contamination from cannabis and "light cannabis" delivered by smoking and vaping: An in vitro study.

External contamination of hair by cannabis smoking requires a careful evaluation in forensic toxicology. Medical and recreational cannabis are increasingly consumed by e-cigarettes, which give rise to side-stream vapor. Moreover, products containing low Δ9-tetrahydrocannabinol (Δ9-THC) and rich in cannabidiol (CBD) started spreading legally. The goal of the present study was to assess whether hair analysis could allow to distinguish the type of delivered product, with low or high Δ9-THC, and the delivering mode, by smoking or vaping. Contamination of blank hair was mimicked by in vitro exposure to low- (0.4%) and high-Δ9-THC (9.7%) products delivered by smoking and vaping within a small confined system. Cannabis vaping extracts were prepared to deliver identical target Δ9-THC doses. Eighty samples were analyzed by ultrahigh-performance liquid chromatography mass spectrometry and quantified for Δ9-THC and CBD. After contamination by cannabis smoking, THC levels were in line with past in vitro and in vivo studies. Samples exposed to cannabis (169.30 ng/mg) showed significantly higher Δ9-THC than hair exposed to "light cannabis" (35.54 ng/mg), and the opposite was seen for the CBD/Δ9-THC ratio. Hair contaminated by vaping or smoking did not show a statistically different Δ9-THC content. Under our in vitro conditions, hair analysis might allow to discriminate whether external contamination is determined by products containing low or high Δ9-THC, but not the delivering mode. More research is needed in real-life conditions, to see whether the same also applies to the interpretation of forensic casework.

EFFECTS OF ACUTE AND CHRONIC CANNABIS/CANNABINOIDS ON COGNITIVE FUNCTION ACROSS THE LIFESPAN

Abstract Cannabis and cannabinoids such as THC (the major psychoactive component of cannabis) tend to impair cognitive performance, but almost all research on this topic has been conducted in young adults. Given that many aged individuals already exhibit cognitive deficits, it is important to determine how cannabis/cannabinoids affect cognition in this population. We used an animal model (young adult and aged rats) to evaluate the effects of both acute cannabis smoke and chronic oral THC on several tests of cognitive function. Both acute smoke (males only) and chronic THC (both sexes) enhanced working memory in aged rats, but neither affected young adults. In contrast, both regimens tended to impair performance on tests of spatial/episodic memory in an age-independent manner. Results suggest that although cannabis has potential for cognitive benefits in aging, its effects likely depend on both the cognitive domain tested and the manner in which it is administered.

An analytical approach for on-site analysis of breath samples for Δ9-tetrahydrocannabinol (THC).

Increased acceptance of cannabis containing the psychoactive component, Δ9-tetrahydrocannabinol (THC), raises concerns about the potential for impaired drivers and increased highway accidents. In contrast to the "breathalyzer" test, which is generally accepted for determining the alcohol level in a driver, there is no currently accepted roadside test for THC in a motorist. There is a need for an easily collectible biological sample from a potentially impaired driver coupled with an accurate on-site test to measure the presence and quantity of THC in a driver. A novel breath collection device is described, which includes three separate sample collectors for collecting identical A, B, and C breath samples from a subject. A simple one-step ethanol extraction of the "A" breath collector sample can be analyzed by UHPLC/selected ion monitoring (SIM) liquid chromatography/mass spectrometry (LC/MS) to provide qualitative and quantitative determination of THC in breath sample in less than 4 min for samples collected up to 6 h after smoking a cannabis cigarette. SIM LC/MS bioanalyses employed d3-THC as the stable isotope internal standard fortified in negative control breath samples for quantitation including replicates of six calibrator standards and three quality control (QC) samples. Subsequent confirmation of the same breath sample in the B collectors was then confirmed by a reference lab by LC/MS/MS analysis. Fit-for-purpose bioanalytical validation consistent with pharmaceutical regulated bioanalyses produced pharmacokinetic (PK) curves for the two volunteer cannabis smokers. These results produced PK curves, which showed a rapid increase of THC in the breath of the subjects in the first hour followed by reduced THC levels in the later time points. A simpler single-point calibration curve procedure with calibrators and QC prepared in ethanol provided similar results. Limitations to this approach include the higher cost and operator skill sets for the instrumentation employed and the inability to actually determine driver impairment.

Cigarette Smoking, Risky Alcohol Consumption, and Marijuana Smoking among University Students in Germany: Identification of Potential Sociodemographic and Study-Related Risk Groups and Predictors of Consumption.

(1) Background: Cigarette smoking, risky alcohol consumption, and marijuana smoking are the most common behaviors related to legal and illicit drug use worldwide, including among university students. To plan effective evidence-based programs to prevent the risky consumption of these substances among university students, the present study aimed to identify potential sociodemographic and study-related risk groups and predictors of consumption. (2) Methods: A cross-sectional online health survey with approximately 270 health-related items was conducted among students at the University of Mainz, Germany. Cigarette smoking, risky alcohol consumption (AUDIT-C score: female ≥ 4, male ≥ 5), and marijuana smoking were chosen as dependent variables. Of the 270 health-related items, 56 were chosen as independent variables and collated into five groups (sociodemographic, psychological, study-related psychosocial, general psychosocial and health behavior). The prevalence of cigarette smoking, risky alcohol consumption, and marijuana smoking was assessed using established and validated instruments. Pearson's chi-square test was used to analyze the differences in prevalence between the sociodemographic and study-related groups, and binary logistic regression was used for analyses with stepwise inclusion of the five variable groups. (3) Results: Of the 3991 university students who entered the analyses, 14.9% reported smoking cigarettes, 38.6% reported risky alcohol consumption, and 10.9% reported smoking marijuana. The prevalence of these differed between genders, fields of study, and aspired degree level, among other factors. Binary logistic regression analyses revealed nine significant predictors (p ≤ 0.05) of cigarette smoking (Nagelkerke R2 = 0.314), 18 significant predictors of risky alcohol consumption (Nagelkerke R2 = 0.270), and 16 significant predictors of marijuana smoking (Nagelkerke R2 = 0.239). (4) Conclusions: This study showed cigarette smoking, risky alcohol consumption, and marijuana smoking among university students in Germany to be associated with multiple factors, especially health behaviors. Furthermore, each of the substances was highly associated with each of the two other substances we examined. Other variable groups, such as psychological or psychosocial variables, seemed to play a rather minor role. Therefore, our recommendation for future prevention programs is that substance use among university students should be addressed as a whole, not just in terms of specific substances.

CHEST COMPUTED TOMOGRAPHY FINDINGS IN CANNABIS SMOKERS : SYSTEMATIC REVIEW

Introduction: In contrast, cannabinoids and nicotine are chemically distinct compounds, with cannabinoids exhibiting a unique set of effects pertaining to aspects such as gene expression, inflammatory mechanisms, immunological modulation, and cellular energy and survival. Consequently, a comparison between the pulmonary effects of cannabis and tobacco consumption is crucial. As a sensitive and repeatable tool for quantifying the airway alterations and alveolar lung damage that are hallmarks of smoking-related emphysema and COPD, noninvasive lung imaging with HRCT scans has developed. In-depth analyses of HRCT images obtained from cannabis consumers were conducted in only two studies. The aim: This study review chest CT findings in cannabis smokers. Methods: For this systematic review, publications that were published from 2012 to 2023 were taken into account during the search process. This was achieved through the utilization of numerous online reference sources, such as Pubmed and SagePub. The decision was made to exclude review articles, previously published works, and incomplete works. Result: We obtained 54 articles from Pubmed and 76 from SagePub. We extracted were 2 article from Pubmed and 4 articles from SagePub. Conclusion: Research shows that patients can experience pneumothorax with bullae and blebs. Those who smoke marijuana can also experience emphysema and chronic bronchitis.

Case Report on a Cocktail Drug Abuser Developing Rhabdomyolysis

Rhabdomyolysis is a medical emergency characterized by the break down of skeletal muscle leading to the release of intracellular contents into the blood stream, which can lead to acute kidney injury and even death. Drug abuse is one of the potential causes of rhabdomyolysis. This case report describes a 18-year-old male with a history of drug abuse who presented to the emergency department with severe muscle pain, weakness, dark and reduced amount of urine. The patient was diagnosed with rhabdomyolysis, which was likely due to a combination of high doses Marijuana, Chlorpheniramine, Dextromethorphan (Corex Syrup), Dicyclomine, Tramadol, Acetaminophen and cigarette smoking over period of 4-5 years, landed up in rhabdomyolysis after joining gym. The patient was immediately started on aggressive intravenous fluid resuscitation, and his urine output and electrolyte levels were closely monitored. Patient required initiation of Hemodialysis over period of 15 days. Patient's muscle pain and weakness gradually improved over the next few days, and he was discharged with a diagnosis of AKI due to Rhabdomyolysis due to drug abuse. Prompt recognition and treatment of rhabdomyolysis are crucial to prevent serious complications, and addiction treatment should be pursued to prevent future episodes of rhabdomyolysis and other drugrelated complications.

Cannabis Use among Cancer Survivors: Use Pattern, Product Type, and Timing of Use.

Despite growing interest in the use of cannabis for the treatment of cancer-related symptoms, there are limited studies that have assessed the use pattern, type, and mode of delivery of cannabis products used by cancer survivors. This study describes the current state of the use pattern, product type, and mode of delivery of cannabis used by cancer survivors. This was a cross-sectional study of cancer survivors from 41 U.S. states who received treatment at the largest NCI-designated comprehensive cancer center. The weighted prevalence of the use patterns, product types, and modes of delivery of cannabis used by cancer survivors was estimated. A total of 1886 cancer survivors were included in the study, with 915 (48% [95% CI: 45-51]) reporting ever using cannabis. Of survivors who had ever used cannabis, 36% (95% CI: 33-40) were current users. Among survivors who reported cannabis use after diagnosis, 40% used cannabis during and after cancer treatment, 35% used cannabis during treatment, and 25% used cannabis after completing their cancer treatment. Additionally, 48% of survivors reported an increase in cannabis use since cancer diagnosis. The commonest types of cannabis products used by cancer survivors were dry leaf cannabis (71%), cannabidiol (CBD) oil (46%), and cannabis candy (40%). Moreover, cancer survivors frequently used baked goods (32%), creams and gels (21%), and tinctures (18%). Furthermore, among ever users, the predominant mode of use was cannabis inhalation/smoking (69%) compared to eating/drinking (59%). More so, the common mode of inhalation/smoking of cannabis products were rolled cannabis cigarettes (79%), pipes (36%), water pipes (34%), vaporizers or vapes (14%), and e-cigarette devices (14%). A substantial number of cancer survivors use cannabis during cancer treatment, with increased use following cancer diagnosis. The forms and modes of delivery of cannabis varied among survivors, with most survivors inhaling or smoking cannabis. There is a need to educate healthcare providers (HCPs) and survivors on current evidence of cannabis use and strengthen cannabis regulatory frameworks to optimize benefits and minimize adverse events from cannabis use during cancer treatment.

An Examination of Bidirectional Associations Between Alcohol Use and Internalizing Symptoms Among Adolescents During the COVID-19 Pandemic

PurposeThis study explores the bidirectional association between internalizing symptoms and alcohol use over three years of the COVID-19 pandemic to examine whether alcohol consumption is associated with higher internalizing symptoms in the next year and vice versa. MethodsWe used linked data from a sample of 2,136 secondary school students who participated in three consecutive waves (2019–2020 [T1], 2020–2021 [T2], and 2021–2022 [T3]) of the Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behaviour study during the pandemic. A random-intercept cross-lagged panel model was used to characterize reciprocal linear relations between internalizing symptoms and alcohol use. ResultsThe findings suggest that students who reported higher levels of alcohol use at T1 experienced increased levels of depression and anxiety in the subsequent year (T2). However, this association was not observed from T2 to T3. Throughout the three-year period, depression and anxiety were not associated with later alcohol use. In males, alcohol use at T1 was a predictor of higher internalizing symptoms at T2 but not from T2 to T3. DiscussionThese results suggest time-sensitive impacts and notable gender differences in the relationship between internalizing symptoms and alcohol use over the pandemic. Given the complexity of impacts, ongoing evaluation of the impact of the pandemic on youth health behaviours is necessary to elucidate these unfolding relationships, especially as the pandemic continues to affect various psychosocial risk factors.

Examining the effect of cannabis cues on cannabis demand in sleep, driving, and typical drug-use contexts

PurposeGiven the expanding legal cannabis market in the U.S., it is vital to understand how context impacts cannabis use. Therefore, we explored the effect of cannabis cues and cannabis-use context on cannabis demand in 79 adults who reported smoking cannabis at least weekly. MethodsParticipants completed a single laboratory session consisting of four hypothetical marijuana purchase tasks (MPTs) involving either a typical use situation or a driving or sleep context. The MPTs were alternated with exposure to cannabis or neutral picture cues based on block randomization by gender. ResultsCannabis cues increased self-reported craving for cannabis (p =.044) but did not significantly alter demand (ps =0.093–0.845). In the driving context, participants demonstrated a significant reduction in cannabis demand, indicated by lower intensity (p <0.001), Omax (p <0.001), and Pmax (p <0.001), breakpoint (p =.003), and higher α (p <0.001). The sleep context was associated with significantly greater α (p <0.006) but nonsignificant effects for other indices (ps =0.123–0.707). Finally, cannabis cues increased Omax (p =.013) and breakpoint (p =.035) in the sleep context but not in the typical-use context. ConclusionsThese findings suggest that cannabis-use behavior is sensitive to contingencies surrounding driving after cannabis use and may also be sensitive to sleep contexts in the presence of cannabis cues. Since this is the first study to examine driving and sleep contexts, we caution against drawing broad conclusions until future research is conducted to replicate these findings.

Analysis of elemental impurities in cannabis following vaporization

The use of vaporizers to inhale cannabis is a technique that has risen in popularity among the American public. There is a general perception that vaporizers are “safer” when compared to more traditional cannabis smoking via combustion (i.e., cigarettes). The inherent use of heated air in vaporizers might reduce the respiratory toxicants or protein toxins by heating cannabis to a temperature where active compounds form in vapor phase. Yet this temperature is below the point of combustion where smoke and associated toxicants are produced. The elemental impurities are a general concern in all botanical products including cannabis and cannabis-derived products (CCDPs). This study aimed to investigate the potential transfer of those metallic elements from cannabis material to cannabis vapor through the vaporization process. A Volcano Digit Vaporizer (Storz & Bickel) was used as the heating device to perform the vaporization. Three cannabis plant materials were evaluated with varying contents of cannabinoids, including a cannabis placebo (<0.01 % Tetrahydrocannabinol (THC), Cannabidiol (CBD) & Cannabinol (CBN)), cannabis with low potency (2.0 % THC/ 0.02 % CBD/ 0.47 % CBN) and high potency (6.7 % THC/ non detectable CBD/ 0.49 % CBN). Baseline elemental impurity levels were evaluated for all cannabis plant materials. Four different types of heat treatment, namely no heat, 30 seconds (s), and 70 s heat treatment, and finally 70 s heat treatment with air flow, were developed for the three cannabis materials and the experimental samples after vaporization were analyzed by an inductively coupled plasma-mass spectrometry (ICP-MS) system. The results showed that sixteen elemental impurities were detected, and all have similar concentration, between 10 ng/g and 8 × 106 ng/g, in the three types of cannabis materials, where Mg was measured with the highest content. Within the four heating treatments evaluated no significant changes of these metallic elements (elemental impurities) were found when compared to the plant materials. This preliminary experimental study evaluated a single vaporizer and three cannabis plant materials suggesting a transfer of metallic elements from cannabis material to cannabis vapor may not occur during the vaporization process under these study conditions.

Abstract A001: Racial differences in cigarettes and marijuana use among acute pancreatitis patients

Abstract Background/Objectives: Smoking increases the risk of pancreatitis and pancreatic cancer, while the effects of marijuana on pancreatic disorders are unknown. Black and White patients with chronic pancreatitis differ in the prevalence of behavioral risk factors, contributing to subsequent racial differences in pancreatic cancer risk, but the behavior pattern has been unexplored in patients with acute pancreatitis (AP). Our objectives were to: 1) estimate the prevalence of current and lifetime cigarettes and marijuana use among AP patients who identify as Black, White, and other races, and examine racial differences in their usage patterns, and 2) describe the type and frequency of marijuana or other cannabis products used among the different racial groups. Methods: We utilized data from an on-going case-crossover study of patients diagnosed with alcohol-associated AP who are recruited from five medical sites in the United States. Hospitalized patients who meet the Revised Atlanta Classification of AP and have an AUDIT-C score of 3 or higher are enrolled in the study. Chi-squared tests were used to assess for racial differences in co-substance use and the type of substance used; while Fisher’s exact test was used to examine racial differences in the frequency of marijuana and other cannabis products used. To account for multiple testing, post-hoc pairwise comparisons were conducted using Holm procedure. Other races included American Indian/Alaska Native, Asian, Brazilian, Mexican, Indian, and people who did not know or could not provide their race. Results: In this analysis, a total of 143 participants were included, among whom 71 identified as White, 46 as Black, and 20 as belonging to other racial backgrounds. Males comprised 69% of patients and the median age was 39 years. Current cigarette smoking and use of marijuana was reported by 51% and 48% patients, respectively. Concurrent cigarette smoking and marijuana use at enrollment was reported in 19%, while 51.8% reported ever use of both substances. Joints/cigars/blunts (JCB) was the most common form of cannabis product used followed by edibles. Majority of the marijuana users used it regularly: daily (36.2%) or 1-6 days a week (38%). While current co-use was not statistically different between races (24% in White, 17% in Black, and 10% in Other), we found that White (62%) and Black (54%) patients were more likely to report ever use of both cigarette and marijuana than other races (20%) (p= 0.013). The differences were also noted for the use of JCB: 38% in White, 52% in Black, and 10% in other races (p=0.006). Conclusions: We identified racial differences in the usage of cigarettes and marijuana, the use of JCB, and the number of marijuana or other cannabis products. Our findings underscore the importance of considering race when addressing multiple substance use in AP patients. Citation Format: Esther A. Adeniran, Dhiraj Yadav, Sungjin Kim, Georgios I. Papachristou, James L. Buxbaum, Joseph R. Pisegna, Stephen J. Pandol, Christie Y. Jeon. Racial differences in cigarettes and marijuana use among acute pancreatitis patients [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A001.

Characterization of cannabinoid plasma concentration, maternal health, and cytokine levels in a rat model of prenatal Cannabis smoke exposure

Cannabis sativa has gained popularity as a “natural substance”, leading many to falsely assume that it is not harmful. This assumption has been documented amongst pregnant mothers, many of whom consider Cannabis use during pregnancy as benign. The purpose of this study was to validate a Cannabis smoke exposure model in pregnant rats by determining the plasma levels of cannabinoids and associated metabolites in the dams after exposure to either Cannabis smoke or injected cannabinoids. Maternal and fetal cytokine and chemokine profiles were also assessed after exposure. Pregnant Sprague–Dawley rats were treated daily from gestational day 6–20 with either room air, i.p. vehicle, inhaled high-Δ9-tetrahydrocannabinol (THC) (18% THC, 0.1% cannabidiol [CBD]) smoke, inhaled high-CBD (0.7% THC, 13% CBD) smoke, 3 mg/kg i.p. THC, or 10 mg/kg i.p. CBD. Our data reveal that THC and CBD, but not their metabolites, accumulate in maternal plasma after repeated exposures. Injection of THC or CBD was associated with fewer offspring and increased uterine reabsorption events. For cytokines and chemokines, injection of THC or CBD up-regulated several pro-inflammatory cytokines compared to control or high-THC smoke or high-CBD smoke in placental and fetal brain tissue, whereas smoke exposure was generally associated with reduced cytokine and chemokine concentrations in placental and fetal brain tissue compared to controls. These results support existing, but limited, knowledge on how different routes of administration contribute to inconsistent manifestations of cannabinoid-mediated effects on pregnancy. Smoked Cannabis is still the most common means of human consumption, and more preclinical investigation is needed to determine the effects of smoke inhalation on developmental and behavioural trajectories.

Impairment of Endothelial Function by Aerosol From Marijuana Leaf Vaporizers.

Marijuana leaf vaporizers, which heat plant material and sublimate Δ-9-tetrahydrocannabinol without combustion, are popular alternatives to smoking cannabis that are generally perceived to be less harmful. We have shown that smoke from tobacco and marijuana, as well as aerosol from e-cigarettes and heated tobacco products, impair vascular endothelial function in rats measured as arterial flow-mediated dilation (FMD). We exposed 8 rats per group to aerosol generated by 2 vaporizer systems (Volcano and handheld Yocan) using marijuana with varying Δ-9-tetrahydrocannabinol levels, in a single pulsatile exposure session of 2 s/min over 5 minutes, and measured changes in FMD. To model secondhand exposure, we exposed rats for 1 minute to diluted aerosol approximating release of uninhaled Volcano aerosol into typical residential rooms. Exposure to aerosol from marijuana with and without cannabinoids impaired FMD by ≈50%. FMD was similarly impaired by aerosols from Yocan (237 °C), and from Volcano at both its standard temperature (185 °C) and the minimum sublimation temperature of Δ-9-tetrahydrocannabinol (157 °C), although the low-temperature aerosol condition did not effectively deliver Δ-9-tetrahydrocannabinol to the circulation. Modeled secondhand exposure based on diluted Volcano aerosol also impaired FMD. FMD was not affected in rats exposed to clean air or water vapor passed through the Volcano system. Acute direct exposure and modeled secondhand exposure to marijuana leaf vaporizer aerosol, regardless of cannabinoid concentration or aerosol generation temperature, impair endothelial function in rats comparably to marijuana smoke. Our findings indicate that use of leaf vaporizers is unlikely to reduce the vascular risk burden of smoking marijuana.

Assessment of prevalence, predictors, reasons and regulations of substance smoking among children in Ghana

BackgroundIn Ghana, it is against the law for children to smoke. Nevertheless, a portion of children in the country do smoke. However, there is a paucity of research on young smokers in Ghana and other sub-Saharan African nations. This study, therefore, investigated the prevalence of smoking, the kinds of substances children smoke, predictors of smoking, reasons for and factors that lead children to smoke, and regulation of smoking among children in Ghana.MethodsIn total, 5024 children aged 8–17 were studied using a cross-sectional convergent parallel mixed method. Descriptive statistics, Person’s Chi-square test, Fisher Exact test, and binary logistic regression were used to analyse the quantitative data. In contrast, thematic analysis was used to analyse the qualitative data.ResultsThe results showed that 3.2% of children had ever smoked. Male children smoked more often than female children. The prevalence of cigarette, marijuana, and shisha smoking was 78.3%, 18%, and 3.7%, respectively. While more male children than female children smoked cigarettes and marijuana, more female children than male children used shisha. Children mainly smoked for fun and due to group culture. In addition, children were influenced by friends; parents, family members, and neighbours who smoke; curiosity; and advertisements and videos to initiate smoking. Despite the availability of regulations and laws regulating tobacco products in public places, tobacco advertisement, promotion, and sale to persons under 18, children are still smoking.ConclusionsChildren who have ever engaged in smoking reported using cigarettes, marijuana, and shisha. Policymakers urgently need to strategise and strengthen their policies, programmes, and interventions to address smoking among children.

In vitro evaluation of cell viability and expression profile of growth factors in mouse Sertoli cells exposed to Delta-9-tetrahydrocannabinol: a mechanistic insight into the cannabinoid-induced testicular toxicity

The potentially adverse effects of cannabis (marijuana), a common leisure compound, on male reproductive performance are a reason for concern. δ-9-tetrahydrocannabinol (THC), the primary active component of marijuana alters testicular cells’ proliferation and function which affects male fertility and causes testicular cells dysfunction and apoptosis. The main objective of this study was to investigate the possible mechanism underlying the toxic effects of THC with a mechanistic insight into Sertoli cell-based reproductive dysfunction. The Mus musculus Sertoli cell line (TM4) was cultured and exposed to different concentrations of THC and, MTT (3-(4, 5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay was then performed for evaluating cell viability. The expression of caspase-3 gene and genes related to growth factors were analyzed by real-time RT-PCR. Western blotting was performed for evaluating protein expression level. THC concentration-dependently decreased the TM4 viability with a significant effect starting at concentration of 1 μM and reaching about 75% of the control level at the concentration of 50 μM (IC25). Moreover, caspase-3 mRNA expression levels significantly increased while growth factors mRNA levels decreased in THC-exposed cells compared to unexposed cells. There was also a significant reduction in related protein levels in THC group. Administration of the THC promotes cytotoxic and apoptotic effects on TM4 cells partly through down-regulation of growth factors expression. Increased apoptosis, over expression of caspase-3, and down-regulation of growth factors expression in Sertoli cells exposed to THC may be a reflection of THC-induced testicular toxicity, which may be partly involved in infertility associated with marijuana smoking or medical cannabis use.

Abstract 14589: Impairment of Endothelial Function by Chronic Cannabis Use: An Interim Analysis of the CANDIDE Study

Background: Increasing cannabis legalization has led to a surge in cannabis use. To understand the consequences for cardiovascular health, we have initiated the CANnabis: Does It Damage Endothelium (CANDIDE) study. Here, we report results of an interim analysis. Aims: To investigate the effects of chronic cannabis product use on endothelial function. Approach: We recruited 44 healthy non-tobacco smokers/vapers, 21-50 yrs, in 3 groups based on chronic cannabis use: cannabis smokers, THC edible users, and nonusers. Participants underwent assessment of brachial artery flow-mediated dilation (FMD) and carotid-femoral pulse wave velocity (PWV). Human umbilical vein endothelial cells (ECs) were exposed to sera from each individual with and without VEGF to determine serum effects on endothelial NO production. Human lung microvascular ECs were also exposed to the individual sera and cell permeability was measured by electric cell-substrate impedance sensing. Results: FMD and VEGF-stimulated NO levels were both significantly lower in cannabis smokers than nonusers (5.7±3.3% vs 12.0±8.0%, p=.037, and 1.1±0.3 nM vs 1.5±0.3 nM, p=.018, respectively; figure), comparable effects to what we have reported for tobacco smokers. In contrast, FMD, but not VEGF-stimulated NO levels, was lower in the THC edible users than nonusers (5.0±4.1% vs 12.0±8.0%, p=.031, and 1.6±0.3 nM vs 1.5±0.3 nM, p=.54). There were no significant differences in other functional properties (p&gt;.48). CD31 and IL-1β, which are circulating inflammatory biomarkers that we showed are elevated in tobacco smokers, were not elevated in cannabis smokers. The inflammatory biomarker PTX3 was lower in cannabis smokers than nonusers (p=.038). Conclusion: Chronic cannabis use impairs endothelial function but may reduce inflammation. Our findings suggest that the impairment caused by smoking cannabis vs edible THC use occurs via distinct mechanisms differing in the involvement of endothelial NO production.

Investigating the associations of age of initiation and other psychosocial factors of singular alcohol, tobacco and marijuana usage on polysubstance use: analysis of a population-based survey in Jamaica

ObjectivesThis study aimed to examine concurrent polysubstance use of alcohol, tobacco and marijuana and determine correlations with access to marijuana, friend and familial drug use habits, risk perception and the...

Cytological changes in respiratory epithelium in association with marijuana smoking

Marijuana is one of the commonly used illicit drugs in Nigeria. This study evaluated the cytological changes in the respiratory epithelium associated with marijuana smoking in Calabar Municipality, Cross River State, Nigeria. This study was a cross- sectional study involving 100 marijuana smokers and 50 marijuana non-smokers, aged 15 years and above. Sputum samples were aseptically collected, and smears prepared. The smears were fixed in ethyl alcohol and were stained using Giemsa and Papanicolaou staining techniques. The stained smears were examined using x10 and x40 objectives of light microscope. Photomicrographs of stained smears were obtained. Data were represented in percentages in tables. Chi-square was used to determine statistical difference between two categorical variables. P-values &lt; 0.05 were considered significant. Marital status, level of education and age of subjects significantly influenced the smoking of marijuana (p=0.001). There was a significant increase in the number of marijuana smokers between the age of 15 – 24(p=0.001) when compared with other age groups. There were also significant abnormalities (p=0.001) observed in the respiratory epithelium of marijuana smokers when compared with non-marijuana smokers. Respiratory cytology smears from marijuana smokers who have smoked for at least 10 years showed mild to moderate metaplasia, numerous acute and chronic inflammatory infiltrates while those who have smoked for more than 10 years showed giant epithelial cells, multinucleated cells and clumps of dysplastic cells. Data from this study showed that marijuana smoking causes inflammatory and dysplastic changes in the respiratory epithelium.