Review draws parallels between cardiovascular harms of cannabis and tobacco smoking
Cannabis smoking produces largely identical combustion chemicals to tobacco and is associated with similar cardiovascular complications including heart attacks, arrhythmias, and strokes, potentially at younger ages.
Quick Facts
What This Study Found
Despite different active ingredients (THC vs nicotine), cannabis and tobacco smoke contain largely identical combustion chemicals. Cannabis-associated cardiovascular complications include acute coronary syndromes, potentially lethal arrhythmias, and ischemic strokes. Different smoking techniques (deeper inhalation, longer breath-holding) may cause longer chemical retention from cannabis.
Key Numbers
The review notes that cannabis smoke contains many of the same 4,000+ chemicals as tobacco smoke, with cardiovascular complications emerging at younger ages in cannabis users.
How They Did This
Literature review of cannabis pharmacology, cardiovascular effects, comparison with tobacco effects, and special populations (adolescents, secondhand smoke, exercise).
Why This Research Matters
The public health messaging that cannabis is "natural" and therefore safe may be masking cardiovascular risks that mirror those already well-established for tobacco, especially when smoked.
The Bigger Picture
Decades of public health work to reduce tobacco smoking may be undermined if cannabis smoking normalizes the inhalation of combustion products. The cardiovascular risks appear to be an effect of combustion, not specific to either plant.
What This Study Doesn't Tell Us
Narrative review without systematic methodology. Concomitant tobacco and cannabis use confounds many studies. Dose-response data are limited. Most cardiovascular case reports are anecdotal.
Questions This Raises
- ?Do non-combustion cannabis consumption methods (edibles, vaporizers) carry the same cardiovascular risks?
- ?Is the cardiovascular risk driven by combustion or by cannabinoids themselves?
Trust & Context
- Key Stat:
- Similar combustion chemicals to tobacco
- Evidence Grade:
- Moderate: comprehensive review drawing on pharmacological, clinical, and epidemiological evidence.
- Study Age:
- Published in 2019.
- Original Title:
- Cannabis Associated "High" Cardiovascular Morbidity and Mortality: Marijuana Smoke Like Tobacco Smoke? A Déjà Vu/Déjà Vécu Story?
- Published In:
- Mini reviews in medicinal chemistry, 19(11), 870-879 (2019)
- Database ID:
- RTHC-02155
Evidence Hierarchy
Summarizes existing research on a topic.
What do these levels mean? →Frequently Asked Questions
Is smoking cannabis as bad for the heart as smoking tobacco?
This review argues yes, with similar combustion chemicals and cardiovascular complications. Longer inhalation and breath-holding may even increase chemical retention from cannabis smoke.
What cardiovascular problems are linked to cannabis?
Acute coronary syndromes (heart attacks), potentially lethal arrhythmias, and ischemic strokes have been associated with cannabis use, particularly when smoked.
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Cite This Study
https://rethinkthc.com/research/RTHC-02155APA
Manolis, Theodora A; Manolis, Antonis A; Manolis, Antonis S. (2019). Cannabis Associated "High" Cardiovascular Morbidity and Mortality: Marijuana Smoke Like Tobacco Smoke? A Déjà Vu/Déjà Vécu Story?. Mini reviews in medicinal chemistry, 19(11), 870-879. https://doi.org/10.2174/1389557518666181114113947
MLA
Manolis, Theodora A, et al. "Cannabis Associated "High" Cardiovascular Morbidity and Mortality: Marijuana Smoke Like Tobacco Smoke? A Déjà Vu/Déjà Vécu Story?." Mini reviews in medicinal chemistry, 2019. https://doi.org/10.2174/1389557518666181114113947
RethinkTHC
RethinkTHC Research Database. "Cannabis Associated "High" Cardiovascular Morbidity and Mort..." RTHC-02155. Retrieved from https://rethinkthc.com/research/manolis-2019-cannabis-associated-high-cardiovascular
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.