Cannabis Associated “High” Cardiovascular Morbidity and Mortality: Marijuana Smoke Like Tobacco Smoke? A Déjà Vu/Déjà Vécu Story?

Background: Cannabis use has increased over the past several years as some countries have legalized its use for the treatment of certain medical conditions and/or for recreational use. Thus, concerns have risen about potential adverse health effects. Increasing number of reports have associated cannabis use with serious cardiovascular (CV) complications. Furthermore, there appears to be a likeness in the harmful health effects, especially on the CV and respiratory systems, of cannabis smoking to those of tobacco smoking. Objective: To review the CV effects of cannabis use and compare them with those of tobacco use. Methods: Articles were reviewed that were published in English literature reporting on cannabis and cannabinoid pharmacology and their effects on the CV system and their consequences. Emphasis was also placed on articles reporting on cannabis use in adolescents, exposure to secondhand smoke, its effect on exercise and finally its inter-relationship and similarities with tobacco use. Results: With growing cannabis use, an increasing number of reports have emerged associating marijuana use with serious and life-threatening CV complications, including acute coronary syndromes, potentially lethal cardiac arrhythmias and ischemic strokes. There are certain similarities of the deleterious CV and respiratory effects of cannabis smoking with those of tobacco smoking. Despite the difference in the active ingredients (tetrahydrocannabinol vs. nicotine), each substance produces a plethora of chemicals when smoked and these are largely identical; furthermore, due to different modes of smoking, cannabis chemicals are retained in the body for a longer time. Of course, concomitant tobacco and cannabis smoking is a perplexing factor in isolating damages specifically pertaining to cannabis use, while the health risk is additive. Although the mechanisms producing CV harm may be somewhat different between these two substances, the outcome appears similar, or even worse, as the effects may emerge at a younger age. Conclusion: There is an increasing concern that, apart from the mental health problem with cannabis smoking, societies may be facing another wave of a déjà vu/déjà vécu phenomenon similar to the tobacco smoking story.

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MP50: Vaping, tobacco and cannabis among patients presenting to the emergency department: a cross-sectional study

CJEM ◽

10.1017/cem.2020.198 ◽

2020 ◽

Vol 22 (S1) ◽

pp. S60-S61

Author(s):

K. Zhou ◽

D. Junqueira ◽

S. Couperthwaite ◽

J. Meyer ◽

B. Rowe

Keyword(s):

Emergency Department ◽

Lung Injury ◽

Tobacco Smoking ◽

Respiratory Symptoms ◽

Cannabis Use ◽

Categorical Variables ◽

Continuous Variables ◽

Cannabis Smoking ◽

Lung Health ◽

Respiratory Conditions

Introduction: Inhaled toxins from tobacco smoking, cannabis leaf smoking as well as vaping/e-cigarette products use are known causes of cardio-respiratory injury. While tobacco smoking has decreased among Canadian adults, there are now several other forms of legal inhalant products. While legal, the evidence of benefit and safety of vaping is limited. Of concern, cases of e-cigarette or vaping products use associated lung injury (EVALI) have been accumulating in the U.S. and now in Canada. Despite this, very little is known about the inhalation exposure of emergency department (ED) patients; this study was designed to explore lung health in the ED. Methods: We investigated the prevalence of exposure to vaping, tobacco and cannabis among patients presenting to a Canadian ED from July to November 2019. Ambulatory (CTAS 2 to 5), stable, adult (≥ 17 years) patients were prospectively identified and invited to complete a survey addressing factors related to lung health (previous diagnosis of respiratory conditions and respiratory symptoms at the ED presentation) and information on current exposure to vaping, tobacco and cannabis smoking. Categorical variables are reported as frequencies and percentages; continuous variables are reported as medians with interquartile range (IQR). The study was approved by the Health Research Ethics Board. Results: Overall, 1024 (71%) of 1433 eligible patients completed the survey. The median age was 43.5 (IQR: 29, 60), and 51% were female. A total of 351 (31%) participants reported having been previously diagnosed with ≥1 respiratory conditions, and 177 (17%) were visiting the ED as a result of ≥1 respiratory symptoms (e.g., cough, shortness of breath, wheezing). Daily tobacco smoking was reported by 190 (19%), and 83 (8%) reported using vaping/e-cigarette products. Cannabis use within 30 days was described by 80 (15%) respondents. Exposure to tobacco and vaping products was reported by 39 (4%) participants, 63 (6%) reported using tobacco in combination with cannabis smoking, and 3% reported combining vaping and cannabis use. Conclusion: Patients seeking care in the ED are exposed to a large quantity of inhaled toxins. Vaping products, considered the cause of the most recent epidemic of severe lung injury, are used in isolation and in combination with other smoking products in Canada. These exposures should be documented and may increase the risk of lung health injuries and exacerbations of chronic respiratory conditions.

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Co-use and Mixing Tobacco With Cannabis Among Ontario Adults

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz238 ◽

2019 ◽

Author(s):

Navitha Jayakumar ◽

Michael Chaiton ◽

Renee Goodwin ◽

Robert Schwartz ◽

Shawn O’Connor ◽

...

Keyword(s):

Health Effects ◽

Tobacco Use ◽

Tobacco Smoking ◽

Evidence Base ◽

Health Concern ◽

Cigarette Use ◽

User Characteristics ◽

Considerable Effort ◽

The Past ◽

Health Monitor

Abstract Introduction The legalization of nonmedical cannabis in 2018 may have important implications for tobacco use in Canada. There is a risk of renormalizing tobacco use with co-use of tobacco and cannabis introducing nontobacco users to tobacco. Co-use is the use of both substances by the same individual at the same time or on different occasions, as well as mixed together. This study assessed the prevalence of co-use and mixing of tobacco and cannabis among Ontario adults and the characteristics of the users. Aims and Methods Data from the 1996 to 2017 cycles of the Centre for Addiction and Mental Health Monitor (n = 4481) were used to examine trends in prevalence and the proportion of Ontario adults co-using and mixing tobacco and cannabis. Logistic regression was used to study associations between user characteristics and co-use and mixing. Results Co-use of cigarettes and cannabis among cannabis users declined from 59.8% in 1996 to 41.7% in 2017. Past-year e-cigarette use was the only predictor of co-use. From 2015 to 2017, 31.1% (95% confidence interval 27.0, 35.9) of Ontario adults who used cannabis reported mixing it with tobacco in the past year. Being white, past-year e-cigarette use, having moderate or high nicotine dependence, and having moderate or high risk for cannabis problems were significant predictors of mixing among cannabis users. Conclusion Given the well-established negative health effects associated with tobacco use, alongside a growing evidence base for negative health effects of cannabis smoking, co-use and mixing could pose a considerable public health concern in the context of legalization. Implications Considerable effort has been expended to reduce tobacco smoking. However, current efforts to reduce tobacco smoking may be diminished since this study found the prevalence of mixing tobacco and cannabis among cannabis users in Ontario to be higher than expected. Mixing tobacco and cannabis may introduce nontobacco smokers to tobacco, exposing them to health risks associated with both cannabis and tobacco smoke. Therefore, there is a need to monitor changes in tobacco use and understanding implications for tobacco control and cessation programs within the changing environment of cannabis legalization in Canada and other jurisdictions.

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Don’t Touch My MIDI Cables: Gender, Technology and Sound in Live Coding

Feminist Review ◽

10.1177/0141778920973221 ◽

2021 ◽

Vol 127 (1) ◽

pp. 90-106

Author(s):

Joanne Armitage ◽

Helen Thornham

Keyword(s):

Lived Experiences ◽

The Body ◽

Human Relationship ◽

Donna Haraway ◽

Kinship Relations ◽

Per Se ◽

Deja Vu ◽

Déjà Vu ◽

Empirical Material

Live coding is an embodied, sensorial and live technological–human relationship that is recursively iterated through sonic and visual outputs based on what we argue are kinship relations between and through bodies and technology. At the same time, and in a familiar moment of déjà vu for feminist scholars, live coding is most often discussed not in relation to the lived and sensory human–technology kinship, but in terms of fetishised code or software, output and agency. As feminist scholars have long argued, emphasising and fetishising code or software, and celebrating output and agency are normatively masculine, white and Western conceptions of technology that feed into the growing valorisation of accelerationist logic whilst also negating embodied, not to mention other (non-white, Western, masculine) bodies, expertise or histories per se. In this article, we want to redress this by drawing on our empirical material on live coding to focus on human–technology kinship and, in so doing, think about failure, slowness and embodiment and about human–technology relations that are more akin to what Alison Kafer (drawing on the work of Donna Haraway) has termed ‘becoming with’ or ‘making kin’. This, we argue, has the potential to shift the focus from the potentialities of technologies on or through the body, towards the generative capacities of mediation (including failure), which are caught up in lived experiences. The question is not only about how the relations of bodies and technologies are played out in certain circumstances but about what might be played out if we reconceptualise these relations in these terms.

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A review of the effects of tobacco smoking on cancer treatment: smoking cessation intervention should be integrated into the cancer care continuum

Journal of Radiotherapy in Practice ◽

10.1017/s1460396919000360 ◽

2019 ◽

Vol 19 (1) ◽

pp. 84-92 ◽

Cited By ~ 1

Author(s):

Rahil Kassim ◽

Ernest Osei ◽

Kelly A. Cronin

Keyword(s):

Smoking Cessation ◽

Cancer Treatment ◽

Cancer Patients ◽

Health Effects ◽

Tobacco Use ◽

Tobacco Smoking ◽

Cancer Care ◽

Care Continuum ◽

Cessation Intervention ◽

Cancer Care Continuum

AbstractBackground:The adverse health effects associated with smoking tobacco have been well investigated, and its detrimental effects on cancer treatment outcomes, efficacy and quality of life (QOL) for cancer patients have also been well documented. Tobacco smoke contains many thousands of chemicals, including a plethora of carcinogens, and the exposure of human cells to these carcinogens, and their metabolic activation, is the main mechanism by which smoking-related cancer is initiated.Materials and Methods:This paper reports on a narrative review of recent studies in the field of effects of tobacco smoking on cancer treatment, including the effects of carcinogens in smoke on carcinogenesis, cell mutations and the immune system. The health effects of smokeless tobacco, effects of tobacco smoking on cancer treatment, and its impact on surgery, radiation therapy and chemotherapy are reported. The potential risks of second primary cancers or recurrence from tobacco use, the effects of second-hand smoking and cancer treatment, the impact of smoking on the QOL after cancer treatment and the need to integrate smoking cessation programs into the cancer care continuum are also reported.Conclusions:Tobacco use has a direct impact on cellular function by inhibiting apoptosis, stimulating proliferation and decreasing the efficacy of cancer treatment; therefore, quitting its use has the potential to improve treatment response rates and survival, as well as reduces the risk of developing second cancers and potentially improves the QOL after treatment. Smoking cessation is one of the most important interventions to prevent cancer and is also essential after the diagnosis of cancer to improve clinical outcomes. Due to the numerous benefits of smoking cessation, it should become a critical component of the cancer care continuum in all oncology programs – from prevention of cancer through diagnosis, treatment, survivorship and palliative care. Evidence-based smoking cessation intervention should be sustainably integrated into any comprehensive cancer program, and the information should be targeted to the specific benefits of cessation in cancer patients.

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Effects of quitting cannabis on respiratory symptoms

European Respiratory Journal ◽

10.1183/09031936.00228914 ◽

2015 ◽

Vol 46 (1) ◽

pp. 80-87 ◽

Cited By ~ 29

Author(s):

Robert J. Hancox ◽

Hayden H. Shin ◽

Andrew R. Gray ◽

Richie Poulton ◽

Malcolm R. Sears

Keyword(s):

Young Adults ◽

Tobacco Use ◽

Tobacco Smoking ◽

Respiratory Symptoms ◽

Estimating Equations ◽

Population Based ◽

Cannabis Use ◽

Sputum Production ◽

Generalised Estimating Equations

Smoking cannabis is associated with symptoms of bronchitis. Little is known about the persistence of symptoms after stopping cannabis use. We assessed associations between changes in cannabis use and respiratory symptoms in a population-based cohort of 1037 young adults.Participants were asked about cannabis and tobacco use at ages 18, 21, 26, 32 and 38 years. Symptoms of morning cough, sputum production, wheeze, dyspnoea on exertion and asthma diagnoses were ascertained at the same ages. Frequent cannabis use was defined as ≥52 occasions over the previous year. Associations between frequent cannabis use and respiratory symptoms were analysed using generalised estimating equations with adjustments for tobacco smoking, asthma, sex and age.Frequent cannabis use was associated with morning cough (OR 1.97, p<0.001), sputum production (OR 2.31, p<0.001) and wheeze (OR 1.55, p<0.001). Reducing or quitting cannabis use was associated with reductions in the prevalence of cough, sputum and wheeze to levels similar to nonusers.Frequent cannabis use is associated with symptoms of bronchitis in young adults. Reducing cannabis use often leads to a resolution of these symptoms.

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