Marijuana Smoking Research Articles

Atrial Fibrillation Occurring After Smoking Marijuana: A Case Report and Review of the Literature.

Atrial fibrillation (AF) is the most common cardiac arrhythmia, occurring primarily in individuals with known risk factors such as advanced age, heart failure, and coronary artery disease. Cannabis use produces several cardiovascular changes resulting in proarrhythmic effects on the heart. A 38-year-old woman with no significant past medical history presented to the emergency department (ED) complaining of palpitations with associated shortness of breath occurring after smoking marijuana. She was found to be in AF. Evaluation in the ED and during hospitalization found no cardiac or metabolic conditions that predisposed to AF. The AF resolved within three hours of onset without intervention. Cannabis use should be considered as a possible etiology of new-onset AF, especially in relatively young patients with no other predisposing risk factors.

Secondhand smoke exposure and asthma status among adolescents: Findings from the 2019–2020 California Student Tobacco Survey

Background and objectivesSecondhand tobacco smoke is associated with worsening asthma symptoms among children. However, the relationship between secondhand marijuana smoke and asthma symptoms among youth has not been examined. This study compares the prevalence of secondhand tobacco and marijuana smoke exposure, overall and by asthma status, among middle and high school students. MethodsThe study assessed participants of the 2019–2020 California Student Tobacco Survey: a large, cross-sectional random sample of 8th, 10th, and 12th graders (N = 158,937). Descriptive analyses examined exposure to combustible tobacco and marijuana secondhand smoke by students’ asthma status and sociodemographic characteristics. ResultsMore students with asthma were exposed to combustible tobacco secondhand smoke (13.4 %) and marijuana secondhand smoke (12.0 %) than students without asthma (10.9 % and 9.3 %, respectively). The prevalence of secondhand marijuana smoke exposure was higher among 12th grade students (12.2 %) while the prevalence of secondhand tobacco smoke exposure was higher among 8th grade students (13.4 %) and those who lived in rural locations (15.4 %). ConclusionsCalifornia students are exposed to marijuana secondhand smoke at similar proportions to combustible tobacco secondhand smoke and more students with asthma are exposed to marijuana secondhand smoke. These results expand the public health issue of secondhand smoke exposure among children with asthma by highlighting the need to examine marijuana secondhand smoke. Given the rapid shift in marijuana laws across the US, exposure to secondhand marijuana smoke is likely to increase. Therefore, vulnerable populations, such as children with asthma, should be prioritized for interventions that aim to alleviate secondhand marijuana exposure.

Associations between Cannabis Consumption Methods and Cannabis Risk Perception.

Given diversified cannabis products, we examined associations between cannabis consumption methods and cannabis risk perception of smoking cannabis 1-2 times a week. Using the 2022 U.S. National Survey on Drug Use and Health data (N = 12,796 past-year adult cannabis users; M = 6127 and F = 6669), we used multinomial and binary logistic regression models. Smoking was the most prevalent method, followed by eating/drinking, vaping, and dabbing. One-half of cannabis users reported no perceived risk of smoking cannabis 1-2 times a week, 37.5% perceived slight risk, 9.2% moderate risk, and 2.9% great risk. Those with moderate or great risk perception had a lower likelihood of using 4+ methods of consumption (e.g., RRR = 0.40, 95% CI = 0.20, 0.77 for great risk perception). Any perceived risk was associated with higher odds of edibles/drinks only (e.g., aOR = 2.81, 95% CI = 1.43, 5.54 for great risk perception). Along with medical use and CUD, sociodemographic factors, mental illness, and other substance use were also significant correlates of cannabis consumption methods. Understanding the varying risk perceptions associated with different consumption methods is needed for harm reduction initiatives. More research is needed on cannabis products, particularly edibles/drinks and dabs/concentrates, to better understand the potential risks associated with them.

Secondhand cannabis smoke exposure and respiratory symptoms among adults living in a state with legalized medical cannabis with limited smoke-free protections

BackgroundLittle is known about the demographic and health correlates of secondhand cannabis smoke (SHCS) exposure, despite increased availability and use of cannabis across the U.S. This study examined the prevalence and correlates of SHCS exposure in a sample of N=5,410 adults living in Oklahoma and the association of SHCS exposure with self-reported respiratory problems. MethodsData were from a repeated cross-sectional online survey of adults ages 18 and older who completed measurements of past 30-day SHCS exposure in the respondent’s home, in a vehicle, and/or in an indoor setting; harm perceptions of SHCS exposure; frequency of current respiratory symptoms; past 30-day use of cannabis, alcohol, and cigarettes ResultsAlmost half (42 %) reported past 30-day SHCS exposure. In bivariate tests, those exposed were male, younger, non-Hispanic (NH) black or Hispanic, reported lower educational and financial attainment, had lower harm perceptions of SHCS exposure, endorsed more respiratory symptoms, and reported past 30-day cannabis and cigarette use (all p’s < 0.01). In an adjusted regression model, young adulthood (ages 18–24), NH black race (vs NH White), and past 30-day cigarette smoking and cannabis use emerged as the strongest correlates of SHCS exposure. In interaction models, respiratory symptoms were highest among those reporting past 30-day SHCS exposure and past 30-day cannabis use. ConclusionSHCS exposure is common and associated with more frequent respiratory symptoms, particularly among cannabis users. Those exposed were more socially and economically vulnerable.

Association between cannabis use and nicotine use persistence among adolescents

IntroductionProspective associations of adolescent cannabis use with nicotine use persistence are not well characterized but are important for informing prevention and policy. This study examined the association of 4 types of cannabis product use with subsequent persistent nicotine product use among adolescents. MethodsWe used prospective data from an adolescent cohort (14–17 years) from Southern California surveyed at baseline and at approximately 6-month follow-up (2022–2023). We incorporated three mutually non-exclusive analytic samples comprised of individuals with baseline past 6-month use of: (1) any nicotine product (N=308 [mean[SD] age = 16.3[0.6] years]), (2) e-cigarettes (n = 276), and (3) any combustible tobacco product (n = 137). Baseline past 6-month cannabis smoking, vaping, edible use, cannabidiol [CBD] or hemp product use, and any cannabis product use (yes/no) were separately modeled as predictors of past 6-month persistent use of any nicotine products, e-cigarettes, and combustible tobacco at follow-up. ResultsBaseline use of any cannabis product was associated with increased odds of persistent use of e-cigarettes or any nicotine product (adjusted odds ratio[OR] range: 1.96–2.66). Cannabis smoking was positively associated with persistent any nicotine product use (adjusted OR=2.19, 95 % CI=1.20–4.02). Cannabis smoking, vaping, and edible use predicted persistent use of e-cigarettes (adjusted OR range: 2.22–2.79). Cannabis product use did not predict combustible tobacco use persistence. Associations of CBD/hemp product use with nicotine use persistence outcomes were all non-significant. ConclusionsAdolescents who use cannabis may be at elevated risk for persistent nicotine use.

Evaluation of a Novel Online Webinar for Health Care Practitioner Education on the Health Effects of Smoking Cannabis in the Airway

Evaluation of a Novel Online Webinar for Health Care Practitioner Education on the Health Effects of Smoking Cannabis in the Airway

Marijuana Use and Hemoglobin Concentrations in NHANES 2009-2018: Implications for Subclinical Hypoxemia.

Cannabis use is rapidly growing in the United States, but its health implications are poorly understood, particularly when compared with cigarette smoking. Previous research conducted on animal models or non-representative populations with small sample sizes has yielded mixed results on the impact of marijuana use on hemoglobin levels, which may reflect subclinical hypoxemia and/or carbon monoxide exposure. We evaluated the association between marijuana use and hemoglobin levels in a nationally representative sample of U.S. adults. This cross-sectional study included 16,038 individuals aged 18 to 59 years enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2018. We related current and former marijuana use with measured hemoglobin levels, with adjustment for demographics, education, housing, and cigarette smoking status in multivariable analyses that incorporated complex survey weights. As candidate positive and negative control exposures, we used similar methods to relate cigarette smoking and benzodiazepine use, respectively, with hemoglobin concentrations. Current marijuana use was associated with significantly higher hemoglobin concentrations. After multivariable adjustment, compared with never use, current marijuana use was associated with a 0.111, 95% CI [0.021,0.201] g/dL higher hemoglobin concentration, whereas former use was associated with a 0.047, 95% CI [-0.018,0.113] g/dL higher concentration (linear trend p=0.01). As hypothesized, cigarette smoking was also associated with higher hemoglobin concentrations, while benzodiazepine use was not. Among American adults, current marijuana use was associated with higher hemoglobin concentrations, as is cigarette smoking but not benzodiazepine use. These results suggest the possibility that marijuana smoking induces subclinical hypoxemia stimulating hemoglobin production. Further confirmation of this observational finding is needed, in light of the increasing medical and recreational use of smoked marijuana products.

Impact of Marijuana Use on Lung Health.

The widespread use of marijuana in the context of increasing legalization has both short- and long-term health implications. Although various modes of marijuana use-smoked, vaped, or ingested-may lead to a wide scope of potential systemic effects, we focus here on inhalational use of marijuana as the most common mode with the lung as the organ that is most directly exposed to its effects. Smoked marijuana has been associated with symptoms of chronic bronchitis and histopathologic changes in airway epithelium, but without consistent evidence of long-term decline in pulmonary function. Its role in immunomodulation, both for risk of infection and protection against a hyperinflammatory host response to infection, has been suggested in animal models and in vitro without conclusive extrapolation to humans. Marijuana smoke contains carcinogens like those found in tobacco, raising concern about its role in lung cancer, but evidence is mixed and made challenging by concurrent tobacco use. Vaping may offer a potential degree of harm reduction when compared with smoking marijuana with reduction of exposure to several toxins, including carbon monoxide, and reduction in chronic respiratory symptoms. However, these potential benefits are counterbalanced by risks including vaping-associated lung injury, potentially more intense drug exposure, and other yet not well-understood toxicities. As more states legalize marijuana and the federal government considers changing this from a Schedule I to a Schedule III controlled substance, we anticipate an increase in prospective medical studies concerning the risks related to marijuana use. This review is based on currently available data concerning the impact of inhaled marijuana on lung health.

Does Marijuana Smoking Increase the Odds of Surgical Site Infection After Orthopaedic Surgery? A Retrospective Cohort Study

OBJECTIVES: Does marijuana smoking increase the risk of surgical site infection (SSI) after open reduction and internal fixation of fractures? METHODS: Design: Retrospective. Setting: Single academic level 1 trauma center in Southern California. Patient Selection Criteria: Adult patients who underwent open treatment for closed fractures between January 2009 and December 2021, had hardware placed, and had at least 6 months of postoperative follow-up. Outcome Measures and Comparisons: Risk factors associated with the development of SSI were compared between current inhalational marijuana users and nonmarijuana users. RESULTS: Complete data were available on 4802 patients after exclusion of 82 who did not have a complete variable set. At the time of surgery, 24% (1133 patients) were current users of marijuana. At the final follow-up (minimum 6 months), there was a 1.6% infection rate (75 patients). The average age of the infection-free group was 46.1 ± 23.1 years, and the average age of the SSI group was 47.0 ± 20.3 (P = 0.73) years. In total, 2703 patients (57%) in the infection-free group were male compared with 48 (64%) in the SSI group (P = 0.49). On multivariate analysis, longer operative times (OR 1.002 [95% CI, 1.001–1.004]), diabetic status (OR 2.084 [95% CI, 1.225–3.547]), and current tobacco use (OR 2.493 [95% CI, 1.514–4.106]) (P &lt; 0.01 for all) were associated with an increased risk of SSI; however, current marijuana use was not (OR 0.678 [95% CI, 0.228–2.013], P = 0.48). CONCLUSIONS: Tobacco use, diabetes, and longer operative times were associated with the development of SSI after open reduction and internal fixation of fractures; however, marijuana smoking was not shown to be associated with the development of SSI. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Loneliness and risky behaviours among mobile fishers in Elmina, Ghana: a convergent parallel mixed-method study

BackgroundLoneliness affects individuals of all age groups, and mobile fishers are susceptible to loneliness due to the nature of their occupation. However, there is no study examining loneliness and risky behaviours among fishers in Ghana. Therefore, the purpose of this study was to examine fishers’ mobility history, prevalence of loneliness, predictors of loneliness, effects of loneliness on fishers, coping strategies to address loneliness, and prevalence of risky behaviour among fishers in Elmina, Ghana.MethodsThis is a convergent parallel mixed-method study involving 385 fishers in Elmina. A questionnaire and interview guides were used to collect data from respondents. Descriptive statistics, Pearson’s chi-square and Fisher exact tests, and binary logistic regression were used to analyse the quantitative data, while the qualitative data were analysed thematically.ResultsFrom the quantitative findings, most fishers were mobile (54.5%) and travelled alone (45.7%). Approximately 83% of the fishers experienced loneliness. Male fishers (AOR = 0.049; 95% CI = 0.003–0.741; p-value = 0.030), fishers affiliated with the African Traditionalist religion (AOR = 0.043; 95% CI = 0.002–0.846; p-value = 0.038), and fishers who travelled with their working colleagues (AOR = 0.002; 95% CI = 0.000-0.023; p-value = ≤ 0.001), were less likely to be experience loneliness. Feeling bored, isolated and worried/anxious were the main perceived effects of loneliness. Alcohol consumption and finding a companion to spend time with were the main strategies fishers used to cope with their loneliness. Most male fishers consumed alcohol (92.5%; p-value = ≤ 0.001) and spent time with companions (73.5%; p-value = ≤ 0.001) to cope with their loneliness. The quantitative and qualitative findings showed that fishers engaged in risky behaviours (excessive alcohol consumption, casual sex, and smoking marijuana and tobacco). From the quantitative findings, more male fishers engaged in excessive alcohol consumption (97.6% vs. 74.5%; p-value = ≤ 0.001), casual sex (88.2% vs. 61.7%, p-value = ≤ 0.001), smoking marijuana (43.0% vs. 13.0%, p-value = ≤ 0.001) and tobacco (49.4% vs. 19.1%; p-value = 0.001) than female fishers.ConclusionsLoneliness and risky behaviours were common among fishers. Therefore, there is an urgent need to design interventions to help reduce loneliness and risky behaviour among fishers.

FEATURES OF ANESTHESIA IN PATIENTS WITH SPECIAL NEEDS. PART 1

The non-medical use of cannabis can negatively impact the morpho-functional state of almost all organs and systems of the human body. During acute intoxication and established drug dependence, it can unevenly distort the effects of drugs for local and general anesthesia, leading to life-threatening complications. Part 1 of this review presents the results of acute and chronic cannabis use on homeostasis. Cerebral vasospasm and atherosclerosis are identified as major etiological factors for cannabis-related cerebrovascular diseases. Young to middle-aged individuals (30–50 years), male gender (male-to-female ratio 3.7:1), and chronic use (86%) are significant independent predictors of neurovascular toxicity, cerebral hypoperfusion, and stroke. Cannabis smoking causes damage to the respiratory mucosa similar to tobacco. Regular cannabis smokers can expect irritation of the upper respiratory tract, swelling, obstruction, chronic cough, bronchitis, lung emphysema, and bronchospasm. Some reports advocate the use of dexamethasone during surgery to alleviate these symptoms. The detrimental effects of chronic cannabis use on liver and kidney functions are somewhat overstated. Disturbances in immune system, thermoregulation, blood clotting, and carbohydrate metabolism in the absence of anesthetic precautions can significantly complicate the patient's condition in the perioperative period. Cannabinoids can interact with drugs from various groups. Awareness of the pathophysiological and biochemical consequences of cannabis use allows anesthesiologists to anticipate and effectively manage perioperative complications in this patient category

Associations between noticing public health education campaigns about cannabis and risk perceptions in the northern Canadian territories: a cross-sectional study.

This study investigated whether noticing cannabis education campaigns was associated with increased cannabis risk perceptions in Canada's three territories following non-medical cannabis legalization. Data were from the Cannabis Policy Study in the Territories, including 2452 participants, age ≥16years residing in Yukon, Northwest Territories and Nunavut. Poisson regression with robust standard errors were used to estimate associations between noticing cannabis education campaigns and moderate to very high risk perceptions of daily cannabis smoking, vaping, edible use and exposure to second-hand cannabis smoke, adjusting for sociodemographic characteristics and cannabis-use frequency. Results were compared with associations with risk perceptions of daily alcohol consumption and cigarette smoking, not included in cannabis education campaigns. Interactions were examined between noticing education campaigns and age group and cannabis-use frequency. Cannabis education campaigns were noticed by 40.4% of respondents, with lower awareness among those with lower education and income. Noticing campaigns was associated with higher risk perceptions of daily cannabis smoking [adjusted risk ratio (RRadj) = 1.09, 95% confidence interval (CI): 1.02-1.16] and vaping (RRadj = 1.09, 95%CI: 1.02-1.16). Significant interactions were not found with age group or cannabis-use frequency. Findings are consistent with modest effects of cannabis education campaigns. Approaches are needed to increase reach of cannabis education campaigns, including among groups with lower education and income.

Cross-ancestry genetic investigation of schizophrenia, cannabis use disorder, and tobacco smoking

Individuals with schizophrenia frequently experience co-occurring substance use, including tobacco smoking and heavy cannabis use, and substance use disorders. There is interest in understanding the extent to which these relationships are causal, and to what extent shared genetic factors play a role. We explored the relationships between schizophrenia (Scz; European ancestry N = 161,405; African ancestry N = 15,846), cannabis use disorder (CanUD; European ancestry N = 886,025; African ancestry N = 120,208), and ever-regular tobacco smoking (Smk; European ancestry N = 805,431; African ancestry N = 24,278) using the largest available genome-wide studies of these phenotypes in individuals of African and European ancestries. All three phenotypes were positively genetically correlated (rgs = 0.17–0.62). Genetic instrumental variable analyses suggested the presence of shared heritable factors, but evidence for bidirectional causal relationships was also found between all three phenotypes even after correcting for these shared genetic factors. We identified 327 pleiotropic loci with 439 lead SNPs in the European ancestry data, 150 of which were novel (i.e., not genome-wide significant in the original studies). Of these pleiotropic loci, 202 had lead variants which showed convergent effects (i.e., same direction of effect) on Scz, CanUD, and Smk. Genetic variants convergent across all three phenotypes showed strong genetic correlations with risk-taking, executive function, and several mental health conditions. Our results suggest that both shared genetic factors and causal mechanisms may play a role in the relationship between CanUD, Smk, and Scz, but longitudinal, prospective studies are needed to confirm a causal relationship.

IgE-Mediated Allergy and Asymptomatic Sensitization to Cannabis Allergens-Review of Current Knowledge and Presentation of Six Cases.

Cannabis allergy is a relatively new phenomenon described in the 1970s. Its increased frequency has been observed over the last years due to the increasing therapeutic and recreational use of cannabis-based products. Sensitization possibly leading to allergy symptoms can occur not only through the smoking of cannabis, but also through ingestion, the inhalation of pollen, or direct contact. The severity of symptoms varies from benign pruritus to anaphylaxis. There is scant information available to support clinicians throughout the entire therapeutic process, starting from diagnosis and ending in treatment. In this review, we present six cases of patients in whom molecular in vitro testing revealed sensitization to cannabis extract and/or cannabis-derived nsLTP molecules (Can s 3). Based on these cases, we raise important questions regarding this topic. The article discusses current proposals and highlights the importance of further research not only on cannabis allergy but also on asymptomatic sensitization to cannabis allergens, which may be ascertained in some percentage of the population.

Does the Risk of Exposure to Marijuana Outweigh the Benefits of Breastfeeding? A Systematic Review

Little is known about the risks associated with marijuana use by mothers during the breastfeeding period. A search of CINAHL, Cochrane, Embase, ProQuest Nursing, and PubMed was conducted using a variety of text words and database MeSH terms, including cannabis, medical marijuana, lactation, breastfeeding, marijuana abuse, and marijuana smoking. Articles included both human and animal studies, and there were no language or date restrictions. Hand search and reference lists were also used to access grey literature or any other important articles. Six articles met the inclusion criteria (n = 3 human studies and n = 3 animal studies). In four of the six studies meeting our inclusion criteria, maternal marijuana exposure was associated with detrimental effects, most notably decreased motor development of children at one year of age and lasting neurodevelopmental changes in rats. Breastfeeding mothers should be advised to reduce or cease their marijuana use completely. This article has been peer reviewed.

Density of cannabis outlets vs. cannabis use behaviors and prevalent cannabis use disorder: findings from a nationally-representative survey.

Thailand recently decriminalized (de facto legalized) cannabis use and sales. However, nationally representative data are scarce with regard to cannabis use behaviors and its association with cannabis outlet density. The objectives of this study are: (1) to describe the prevalence of cannabis use behaviors and cannabis use disorder among the general adult population of Thailand; (2) to describe the extent that the density of cannabis outlets is associated with cannabis use behaviors, cannabis use disorder, and the amount of cannabis smoked per day. We conducted a community-based cross-sectional study in 11 provinces and the Bangkok Metropolitan Area. Participants were residents of sampled communities aged 20 years or older. We requested literate participants to self-administer the questionnaire and interviewed participants who could not read. We analyzed data using descriptive statistics with sampling weight adjustments and multivariate logistic regression analyses. The prevalence of current cannabis use was 15 percent. At a 400-m radius, participants who reported three cannabis outlets had 4.2 times higher odds of being current users than participants who reported no outlet (Adjusted OR = 4.82; 95% CI [3.04-7.63]). We found no association between outlet density and hazardous cannabis use or cannabis use disorder, nor association with the amount of cannabis use among cannabis smokers. The patterns of association between outlet density and cannabis use behaviors were inconsistent. Furthermore, limitations regarding outlet density measurement and lack of temporality should be considered as caveats in the interpretation of the study findings.

A Study of Pupil Response to Light as a Digital Biomarker of Recent Cannabis Use

Introduction: Given the traffic safety and occupational injury prevention implications associated with cannabis impairment, there is a need for objective and validated measures of recent cannabis use. Pupillary light response may offer an approach for detection. Method: Eighty-four participants (mean age: 32, 42% female) with daily, occasional, and no-use cannabis use histories participated in pupillary light response tests before and after smoking cannabis ad libitum or relaxing for 15 min (no use). The impact of recent cannabis consumption on trajectories of the pupillary light response was modeled using functional data analysis tools. Logistic regression models for detecting recent cannabis use were compared, and average pupil trajectories across cannabis use groups and times since light test administration were estimated. Results: Models revealed small, significant differences in pupil response to light after cannabis use comparing the occasional use group to the no-use control group, and similar statistically significant differences in pupil response patterns comparing the daily use group to the no-use comparison group. Trajectories of pupillary light response estimated using functional data analysis found that acute cannabis smoking was associated with less initial and sustained pupil constriction compared to no cannabis smoking. Conclusion: These analyses show the promise of pairing pupillary light response and functional data analysis methods to assess recent cannabis use.

Racial Disparities in Patterns and Modes of Current and Daily Marijuana Use among Adults Living with Children.

This study sought to examine racial disparities in marijuana use among U.S. adults living with children. Data are drawn from the 2022 Behavioral Risk Factor Surveillance System to examine the prevalence of current (past month) and frequent (≥20 days in the last 30 days) marijuana use along with the mode of marijuana use by 7 racial and ethnic groups (non-Hispanic [NH] White, NH-Black, Hispanic, NH American Indian or Alaskan Native [AI/AN], NH-Asian, NH Native Hawaiian or other Pacific Islander only [NH/PI], and other/multiple races, n=22,659). Compared to NH White adults with children, NH Black adults had a higher prevalence of current marijuana use (23.1% vs. 16.9%, p=0.003) and NH AI/AN adults had two times higher prevalence of frequent use (17.3% vs. 8.4%, p=0.0003). Adults living in recreational marijuana legal states (vs. no) were also more likely to report marijuana use, and there were significant age × race/ethnicity and education × race/ethnicity interactions (p<0.05) on marijuana use. Regarding the mode of use, racial minority users except Asians also reported a higher prevalence of smoking marijuana than their White counterparts. Substantial racial disparities in marijuana use patterns among adults who live with children highlight a potential risk for adolescents' health. Addressing these differences is essential for promoting equitable health outcomes in diverse communities.

A qualitative assessment of blunt smokers' perceptions and receptivity to non-tobacco blunt wraps.

The recent debut of the non-tobacco blunt wrap (N-TBW) for smoking cannabis has received little attention from the tobacco control community. The present study is intended to assess blunt smokers' perceptions and receptivity to N-TBWs, which are being marketed as an alternative to cigarillos and other tobacco products used for making blunts. Current blunt smokers (n=41) were recruited from social media platforms to participate in one of nine two-hour focus groups held between October 2022 and May 2023. Six topics ranging from social aspects of blunt smoking to impediments to switching to N-TBWs were discussed. A domain analysis was utilized in uncovering semantic relationships between a given variable (e.g., uneven burn rate) and outcome (e.g., not using N-TBWs). Blunt smokers conveyed interest in the N-TBWs because of health concerns about tobacco. Yet, the following three main barriers impede blunt smokers use of N-TBWs: lack of awareness and accessibility of the N-TBW, familiarity with preparing and smoking a traditional blunt, and incomparability of the tobacco blunt wrap (e.g., cigarillo). The latter was the most formidable challenge as participants expressed several negative product features of N-TBWs (e.g., flimsy material) relative to cigarillos. The N-TBW is unlikely to displace the cigarillo in the near-term future. A more likely scenario is that blunt smokers will continue to use cigarillos with intermittent use of N-TBWs in situational settings. If this occurs, then blunt smokers will continue to be exposed to harmful tobacco products.

Association between non-healing precancerous oral lesions and ulcers with tobacco smoking: A population-based study

BackgroundThis study aims to identify early detection of precancerous lesions amongst high-risk individuals (motor park workers). Though anecdotal evidence suggests they are high users of alcohol, marijuana, and cigarette smoking which are prominent risk factors for the occurrence of oral cancers the occurrence of precancerous lesions in this group has not been determined. MethodThis was a prospective cross-sectional study of a target population of motor park workers (40 years and above). Participants were selected from motor parks in Lagos. All participants had an examination of oral mucosa done for pre-cancerous or cancerous lesions. All suspected mucosa were stained with toluidine blue. All positively stained mucosa were repeated after 1 week for confirmation blue for suspicious cases. Positive cases were biopsied and histology was determined. ResultA total of 453 participants completed the survey. The mean age of participants was 39.4 years (SD: 12.5), 52.8 % were male, while 47.2 % were female. A majority of ever and current smokers did not have oral ulcers, and all the participants with oral ulcers did not indicate a history of smoking. a history of ever-smoking was significantly associated with higher odds of oral lesions in both bivariate (OR: 4.58; 95 % CI: 2.04,10.29; p:<0.001) and multivariate models (OR:2.76). ConclusionSmoking was significantly associated with oral pre-cancerous lesions in this study.