Cannabis use among adults with congenital heart disease was common globally, with co-use having the most negative effects

Among 4,028 adults with congenital heart disease across 15 countries, cannabis use was common (8% of men, 4% of women) and co-use with tobacco had the most negative impact on mental health.

Moons, Philip et al.·The Canadian journal of cardiology·2019·Moderate EvidenceCross-Sectional
RTHC-02192Cross SectionalModerate Evidence2019RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=4,028

What This Study Found

Cannabis-only use had a negligible effect on physical functioning, mental health, and quality of life. Tobacco-only had a small negative effect. Co-use of both had the most detrimental effects, particularly a moderate negative impact on mental health. Large intercountry variation was observed.

Key Numbers

4,028 adults with CHD from 15 countries; men: 14% tobacco, 8% cannabis, 4% both; women: 11% tobacco, 4% cannabis, 1% both. Switzerland highest smoking (24% men); Canada highest cannabis (19% men).

How They Did This

Cross-sectional APPROACH-IS study of 4,028 adults with CHD from 15 countries, using validated questionnaires with propensity-weighted doubly robust estimation to balance groups.

Why This Research Matters

Adults with congenital heart disease are a uniquely vulnerable population for substance use effects. Knowing that cannabis alone has negligible cardiovascular impact but co-use with tobacco is harmful can inform clinical counseling.

The Bigger Picture

The finding that cannabis alone had negligible impact on patient-reported outcomes in a cardiovascularly vulnerable population is noteworthy, though it does not address acute cardiovascular events, which are typically captured through ER data rather than surveys.

What This Study Doesn't Tell Us

Cross-sectional design. Self-reported substance use. Cannot assess acute cardiovascular events. Propensity weighting cannot fully eliminate confounding. Variable legal status of cannabis across 15 countries affects reporting.

Questions This Raises

  • ?Does the negligible effect of cannabis-only use in CHD patients hold up when examining acute cardiovascular events?
  • ?Would cannabis cessation improve mental health outcomes for co-users?

Trust & Context

Key Stat:
Co-use most harmful to mental health
Evidence Grade:
Moderate: large international sample with sophisticated statistical methods, but cross-sectional and self-reported.
Study Age:
Published in 2019.
Original Title:
Prevalence and Effects of Cigarette Smoking, Cannabis Consumption, and Co-use in Adults From 15 Countries With Congenital Heart Disease.
Published In:
The Canadian journal of cardiology, 35(12), 1842-1850 (2019)
Database ID:
RTHC-02192

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Is cannabis safe for people with heart conditions?

In this survey of 4,028 adults with congenital heart disease, cannabis-only use had negligible effects on self-reported functioning, but this does not address acute cardiovascular events.

Is combining cannabis and tobacco worse?

Yes, co-use of cannabis and tobacco had the most detrimental effects, particularly on mental health, compared to using either substance alone.

Read More on RethinkTHC

Cite This Study

RTHC-02192·https://rethinkthc.com/research/RTHC-02192

APA

Moons, Philip; Luyckx, Koen; Kovacs, Adrienne H; Holbein, Christina E; Thomet, Corina; Budts, Werner; Enomoto, Junko; Sluman, Maayke A; Yang, Hsiao-Ling; Jackson, Jamie L; Khairy, Paul; Cook, Stephen C; Chidambarathanu, Shanthi; Alday, Luis; Eriksen, Katrine; Dellborg, Mikael; Berghammer, Malin; Johansson, Bengt; Mackie, Andrew S; Menahem, Samuel; Caruana, Maryanne; Veldtman, Gruschen; Soufi, Alexandra; Fernandes, Susan M; White, Kamila; Callus, Edward; Kutty, Shelby; Apers, Silke. (2019). Prevalence and Effects of Cigarette Smoking, Cannabis Consumption, and Co-use in Adults From 15 Countries With Congenital Heart Disease.. The Canadian journal of cardiology, 35(12), 1842-1850. https://doi.org/10.1016/j.cjca.2019.07.635

MLA

Moons, Philip, et al. "Prevalence and Effects of Cigarette Smoking, Cannabis Consumption, and Co-use in Adults From 15 Countries With Congenital Heart Disease.." The Canadian journal of cardiology, 2019. https://doi.org/10.1016/j.cjca.2019.07.635

RethinkTHC

RethinkTHC Research Database. "Prevalence and Effects of Cigarette Smoking, Cannabis Consum..." RTHC-02192. Retrieved from https://rethinkthc.com/research/moons-2019-prevalence-and-effects-of

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.