Cannabis Use Disorder Linked to 2.4x Higher Mortality in Hospitalized Asthma Patients | Research

The takeaway

Among 552,160 asthma hospitalizations, patients with cannabis use disorder had 2.4 times higher in-hospital mortality and 1.35 times higher odds of severe exacerbations after adjustment.

pulmonologists, emergency medicine clinicians, asthma patients who use cannabis, public health officials

What the researchers found

CUD was present in 4.2% of asthma hospitalizations (23,300 patients). CUD patients were younger (mean 35.3 vs. 51.4 years) and more often male. Adjusted mortality OR: 2.40 (95% CI 1.62-3.55). Severe exacerbation adjusted OR: 1.35 (95% CI 1.07-1.71). Hospital charges were significantly higher in CUD group. No difference in length of stay.

Why it matters

With over 300 million people worldwide affected by asthma and increasing cannabis use, understanding how CUD affects asthma outcomes has direct clinical implications for a large population.

The numbers in context

552,160 asthma hospitalizations. 4.2% (23,300) had CUD. CUD: mean age 35.3 vs. 51.4 years. Mortality: aOR 2.40 (CI 1.62-3.55). Severe exacerbation: aOR 1.35 (CI 1.07-1.71). Higher hospital charges: +$2,091 (p=0.004). No LOS difference.

How the study worked

Retrospective cohort analysis of Nationwide Inpatient Sample (2016-2021). 552,160 asthma hospitalizations stratified by CUD status. Logistic regression for mortality and exacerbation risk; linear regression for charges and LOS, adjusted for demographics and hospital factors.

What this study cannot tell us

Administrative database with ICD coding limitations. CUD diagnosis does not specify active vs. historical use or consumption method. Cannot determine if cannabis directly caused worse outcomes. Healthy user bias unlikely here since CUD implies problematic use. Residual confounding possible.

How to read the evidence

Very large national dataset with adjusted analyses, but administrative data limitations and potential residual confounding limit to moderate.

When this study was published

NIS data from 2016-2021.

The bigger picture

The 2.4x mortality risk is striking, though the younger age and demographic differences of CUD patients suggest possible confounders beyond cannabis itself. The adjusted analysis attempted to address this, but residual confounding remains possible.

Questions still open

Does cannabis smoking specifically worsen asthma outcomes, or is CUD a marker for other risk factors?
Would edible cannabis users show the same associations?

Common questions

Is cannabis dangerous for people with asthma?

This study found asthma patients with cannabis use disorder had 2.4 times higher in-hospital mortality and more severe exacerbations. However, the study cannot determine if cannabis directly caused worse outcomes or if CUD is a marker for other risk factors.

Does the way you use cannabis matter for asthma?

The study could not distinguish between smoking, vaping, or edible cannabis use. Since inhaled cannabis would directly irritate airways, the route of consumption likely matters but was not assessed.

Read the original research

The Effect of Cannabis Use Disorder on Mortality and Other Outcomes in Asthma: A Nationwide Analysis (2016-2021).

Cureus, 17(10), e94969

View on PubMed ↗Publisher’s paper ↗

Citation

Sule-Saa, Samuel; Hein, Pyae Phyo; Sackey, Jeffrey A; Pinkrah, Daniel; Towfig, Muhanned; Akella, Anusha; Kotei, Rebecca; DiCasoli, Richard; Sherazi, Andleeb; Panigrahi, Kalpana. (2025). The Effect of Cannabis Use Disorder on Mortality and Other Outcomes in Asthma: A Nationwide Analysis (2016-2021).. Cureus, 17(10), e94969. https://doi.org/10.7759/cureus.94969