Cannabis, tobacco smoking, and lung function: a cross-sectional observational study in a general practice population
Cannabis, tobacco smoking, and lung function: a cross-sectional observational study in a general practice population
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DOI：
10.3399/bjgp15x683521
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发表时间：
2015-02-01
影响因子：
5.9
通讯作者：
Reid, Peter
中科院分区：
文献类型：
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作者：
Macleod, John;Robertson, Roy;Reid, Peter
研究背景吸食大麻引起的健康问题主要集中在吸食大麻与精神病的潜在关系上，但吸食大麻对呼吸健康的影响较少受到关注。目的调查吸烟者与吸烟者加吸食大麻与呼吸健康和肺功能不良后果之间的关系。设计与设置采用横断面设计，包括两组：吸烟者和吸烟者，吸烟者和吸大麻联合吸烟者。招募是在苏格兰的一家全科诊所进行的，共有12 500名患者。方法测量的暴露是吸烟(包年数)和吸食大麻(联合年数)。通过自我报告记录大麻类型(树脂、草药或两者兼而有之)。使用NHANES和MRC问卷记录呼吸道症状。肺功能测定采用肺活量测定法(FEV1/FVC)。结果受试者500人(男242人)。单纯吸烟者的平均年龄为45岁；接触烟草的中位数为25年。吸食大麻和吸烟者的平均年龄为37岁；烟草暴露的中位数为19包年，当烟草与大麻一起吸烟时，这一数字上升到22.5岁。虽然烟草和大麻的使用与呼吸道症状的报告增加有关，但在那些也吸食大麻的人中，这一比例更高。烟草和大麻使用者都有肺功能受损的证据，但在完全校正的分析中，每多使用一年大麻就会使慢性阻塞性肺疾病的患病率增加0.3%(95%可信区间=0.0至0.5)。结论在主要吸食树脂大麻和烟草的成年人中，观察到与大麻使用有关的对呼吸健康的额外不良影响。
BackgroundHealth concerns around cannabis use have focused on the potential relationship with psychosis but the effect of cannabis smoking on respiratory health has received less attention.AimTo investigate the association between tobacco-only smoking compared with tobacco plus cannabis smoking and adverse outcomes in respiratory health and lung function.Design and settingThe design was cross-sectional with two groups recruited: cigarette smokers with tobacco pack-years; cannabis smokers with cannabis joint-years. Recruitment occurred in a general practice in Scotland with 12 500 patients.MethodExposures measured were tobacco smoking (pack-years) and cannabis smoking (joint-years). Cannabis type (resin, herbal, or both) was recorded by self-report. Respiratory symptoms were recorded using NHANES and MRC questionnaires. Lung function was measured by spirometry (FEV1/FVC ratio).ResultsParticipants consisted of 500 individuals (242 males). Mean age of tobacco-only smokers was 45 years; median tobacco exposure was 25 pack-years. Mean age of cannabis and tobacco smokers was 37 years; median tobacco exposure was 19 pack-years, rising to 22.5 when tobacco smoked with cannabis. Although tobacco and cannabis use were associated with increased reporting of respiratory symptoms, this was higher among those who also smoked cannabis. Both tobacco and cannabis users had evidence of impaired lung function but, in fully adjusted analyses, each additional joint-year of cannabis use was associated with a 0.3% (95% confidence interval = 0.0 to 0.5) increase in prevalence of chronic obstructive pulmonary disease.Conclusion In adults who predominantly smoked resin cannabis mixed with tobacco, additional adverse effects were observed on respiratory health relating to cannabis use.