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Commentary: Ahead of the Curve |

Cannabis Smoking in 2015Cannabis Smoking and Lung Health: A Concern for Lung Health?

Jason R. Biehl, MD; Ellen L. Burnham, MD
Author and Funding Information

From the Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Denver, CO.

CORRESPONDENCE TO: Ellen L. Burnham, MD, Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, 12700 E 19th Ave, Room 9004, Mailstop C272, Aurora, CO 80045; e-mail: ellen.burnham@ucdenver.edu


FUNDING/SUPPORT: Funding support was provided through National Institutes of Health [Grant T32HL007085 to Dr Biehl].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(3):596-606. doi:10.1378/chest.15-0447
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Recent legislative successes allowing expanded access to recreational and medicinal cannabis have been associated with its increased use by the public, despite continued debates regarding its safety within the medical and scientific communities. Despite legislative changes, cannabis is most commonly used by smoking, although alternatives to inhalation have also emerged. Moreover, the composition of commercially available cannabis has dramatically changed in recent years. Therefore, developing sound scientific information regarding its impact on lung health is imperative, particularly because published data conducted prior to widespread legalization are conflicting and inconclusive. In this commentary, we delineate major observations of epidemiologic investigations examining cannabis use and the potential associated development of airways disease and lung cancer to highlight gaps in pulmonary knowledge. Additionally, we review major histopathologic alterations related to smoked cannabis and define specific areas in animal models and human clinical translational investigations that could benefit from additional development. Given that cannabis has an ongoing classification as a schedule I medication, federal funding to support investigations of modern cannabis use in terms of medicinal efficacy and safety profile on lung health have been elusive. It is clear, however, that the effects of inhaled cannabis on lung health remain uncertain and given increasing use patterns, are worthy of further investigation.

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