Cannabis Respiratory Research

Cannabis consumption and risk of asthma: a systematic review and meta-analysis.

Malvi, Ajay · 2025

The pooled odds ratio for asthma diagnosis among cannabis users was 1.31 (95% CI: 1.19-1.44), indicating 31% greater odds compared to non-users.

Cannabis Use Disorder Emergency Department Visits and Hospitalizations and 5-Year Mortality.

Myran, Daniel T · 2025

Within 5 years of incident hospital-based CUD care, 3.5% of individuals died compared to 0.6% of matched general population members.

Perception of harm is strongly associated with complete ban on in-home cannabis smoking: a cross-sectional study.

Tripathi, Osika · 2024

Those who perceived secondhand cannabis smoke as "extremely harmful" had 6x higher odds of a complete home smoking ban (OR=6.0) compared to those rating it "totally safe." Even moderate harm perception ("somewhat harmful") was associated with 2.6x higher odds of a ban.

Perceptions of Safety of Daily Cannabis vs Tobacco Smoking and Secondhand Smoke Exposure, 2017-2021.

Chambers, Julia · 2023

Among 5,035 US adults surveyed in 2017, 2020, and 2021, the perception that daily cannabis smoking is safer than tobacco increased from 36.7% to 44.3% (P<0.001).

Association between Substance Misuse and Outcomes in Critically III Patients with Pneumonia.

Reynolds, Paul M · 2023

Alcohol misuse (5.0% of patients) was associated with increased in-hospital mortality (adjusted OR 1.12, 95% CI: 1.06-1.19).

Nationwide Trends in Hospitalizations and Outcomes of Pulmonary Circulation Disorders Among Patients With Cannabis Use Disorder in the United States.

Jain, Akhil · 2022

Among 3,307,310 cannabis-related hospitalizations, 20,328 (0.61%) involved pulmonary circulation disorders.

Smoking Behaviors and Prognosis in Patients With Non-Muscle-Invasive Bladder Cancer in the Be-Well Study.

Kwan, Marilyn L · 2022

Longer cigarette smoking duration and more pack-years were associated with higher recurrence risk in a dose-dependent manner (40+ years: HR 2.36; 40+ pack-years: HR 1.97).

Cannabis use and risks of respiratory and all-cause morbidity and mortality: a population-based, data-linkage, cohort study.

Vozoris, Nicholas T · 2022

No significant difference in respiratory-related ER visits/hospitalizations between cannabis users and controls (OR 0.91, 95% CI 0.77-1.09).

Cannabis vaping among adults in the United States: Prevalence, trends, and association with high-risk behaviors and adverse respiratory conditions.

Boakye, Ellen · 2021

Cannabis vaping doubled nationally from 1.0% to 2.0% between 2017 and 2019, with the largest increase among young adults (1.2% to 3.9%).

Predictors of vaping marijuana initiation among US adolescents: Results from the Population Assessment of Tobacco and Health (PATH) study Wave 3 (2015-2016) and Wave 4 (2016-2018).

Lee, Juhan · 2021

Adolescents who already used other marijuana products had nearly 8 times the odds of initiating marijuana vaping, while e-cigarette users had about twice the odds..

Vitamin E Acetate in Bronchoalveolar-Lavage Fluid Associated with EVALI.

Blount, Benjamin C · 2020

Vitamin E acetate was detected in bronchoalveolar lavage fluid from 48 of 51 EVALI patients (94%) across 16 states but was absent in all 99 healthy comparators.

Characteristics of a Multistate Outbreak of Lung Injury Associated with E-cigarette Use, or Vaping - United States, 2019.

Perrine, Cria G · 2019

As of September 2019, 805 cases of vaping-associated lung injury were reported.

Impact of cannabis smoking in patients with COPD: A retrospective cross-sectional study in a safety- net hospital.

Cherian, Sujith V · 2026

Combined cannabis+tobacco smokers with COPD had significantly higher FVC (2.69 vs 2.33L), RV (4.09 vs 3.67L), TLC (7.13 vs 6.34L), and more bullous emphysema (17% vs 4%, p=0.02) compared to tobacco-only smokers..

Clinical, physiological, imaging and molecular responses to cannabis smoking: the Canadian Users of Cannabis Smoke (CANUCK) study.

Leung, Clarus · 2026

The CANUCK study examined 139 cannabis smokers (categorized by joint-year exposure: low ≤5, moderate 5–20, high >20 joint-years) alongside 57 never-smokers, using an unusually comprehensive battery of tests. Cannabis smokers at all exposure levels reported worse respiratory symptoms than never-smokers.

Joint Association of Methamphetamine and Cannabis Use as Risk Factors for Asthma Exacerbations Requiring Hospitalization: A Retrospective Analysis.

Musa, Amal M · 2026

Methamphetamine use alone showed a trend toward mechanical ventilation but was not significant.

Prevalence, Patterns, and Correlates of Cannabis-Cigarette Co-Use: Findings From a Multi-State Rapid-Response Survey in the U.S., 2023-2024.

Xue, Zheng · 2026

45% of current cigarette smokers reported concurrent cannabis use, compared to 24.5% of former smokers and 12.3% of never smokers.

Tracking metal presence in cannabis vaping products from source to inhalation.

Gajdosechova, Zuzana · 2025

Legal Canadian cannabis vape liquids contained metal particles (Al, Co, Cr, Cu, Ni, Sn, Zn) originating from device components.

Cannabis use and its impact on respiratory physiology and lung cancer risk: Mechanistic and epidemiological insights (Review).

Georgakopoulou, Vasiliki Epameinondas · 2025

Cannabis smoke contains carcinogenic compounds similar to tobacco, and chronic smoking causes cough, sputum, and wheezing resembling chronic bronchitis.

Comparison of selected metals in the fillers of 14 commercial hemp cigarette brands to commercial tobacco cigarettes.

Gray, Naudia R · 2025

Researchers analyzed 14 commercial hemp cigarette brands for nine metals and compared them to published data on tobacco cigarettes and little cigars.

Impact of medical and recreational cannabis laws on inpatient visits for asthma.

Jayawardhana, Jayani · 2025

States with medical cannabis dispensaries experienced a 14.12% increase in inpatient asthma visits compared to states without.

Cannabinoid Vaping Products: Regulation, Composition, Toxicological Effects, and Emerging Research.

Love, Charlotte A · 2025

Hemp-derived cannabinoid vaping products pose multiple respiratory risks: high cannabinoid concentrations, contaminants (heavy metals, flavoring agents), and harmful byproducts from heating.

Cannabis concentrate vaping chemistry.

Munger, Kaelas R · 2025

Vaping cannabis concentrates (50%+ cannabinoid products) produces harmful aerosol toxicants including isoprene, 3-methylcrotonaldehyde, and other volatile compounds.

The Impact of Dual Cannabis and Tobacco Smoking in Young Patients With Lung Cancer: Results From the Prospective "Environment and Lung Cancer" Study.

Pradère, Pauline · 2025

In a prospective study of 150 lung cancer patients aged 60 or under, 39% smoked both cannabis and tobacco (CTSs), 52% smoked only tobacco (TSs), and 9% were nonsmokers.

Inhaled Cannabis, Asthma, and Chronic Obstructive Pulmonary Disease: A Population-Based Cross-Sectional Study of n = 379,049.

Rustagi, Alison S · 2025

Daily inhaled cannabis was associated with higher odds of asthma (aOR 1.44) and COPD (aOR 1.27) after adjusting for tobacco use.

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

Sule-Saa, Samuel · 2025

CUD was present in 4.2% of asthma hospitalizations (23,300 patients).

Exposure to Secondhand Cannabis Smoke Among Children.

Tripathi, Osika · 2025

Children with reported secondhand cannabis smoke exposure had significantly higher odds of wheezing (aOR=2.1, 95% CI: 1.5-2.9), nighttime cough (aOR=1.8, 95% CI: 1.3-2.5), and emergency department visits for respiratory complaints (aOR=1.6, 95% CI: 1.1-2.3).

Increased active pulmonary tuberculosis risk from sharing bong of cannabis: a case-control study from Thailand.

Chumchuen, Kemmapon · 2024

After adjusting for covariates, smoking and sharing a cannabis bong had an odds ratio of 4.22 (95% CI: 1.47-12.07) for TB.

Secondhand cannabis smoke exposure and respiratory symptoms among adults living in a state with legalized medical cannabis with limited smoke-free protections.

Cohn, Amy M · 2024

SHCS exposure was reported by 42% of adults.

Cardiovascular and Respiratory Effects of Cannabis Use by Route of Administration: A Systematic Review.

Muheriwa-Matemba, Sadandaula Rose · 2024

Most cannabis health research lumps all users together regardless of whether they smoke flower, vape concentrates, eat edibles, or dab.

Secondhand smoke exposure and asthma status among adolescents: Findings from the 2019-2020 California Student Tobacco Survey.

Satybaldiyeva, Nora · 2024

About 12% of students with asthma reported exposure to secondhand marijuana smoke, compared to 9.3% of students without asthma.

Association of vaping with respiratory symptoms in U.S. young adults: Nicotine, cannabis, and dual vaping.

Sun, Ruoyan · 2024

Vaping is often positioned as a safer alternative to smoking, but this large national survey reveals that vaping — whether nicotine, cannabis, or both — is associated with respiratory symptoms in young adults. Among 8,033 Americans aged 18-24 surveyed in 2021, the breakdown was: 75.4% didn't vape, 15% vaped nicotine only, 4.7% vaped cannabis only, and 4.9% vaped both.

Clearing the air: Heightened perception of harm from secondhand cannabis smoke exposure is associated with no in-home cannabis smoking in a 21-country convenience sample.

Tripathi, Osika · 2024

Those at the 75th percentile (vs 25th) of perceived harm from secondhand cannabis smoke had 70% higher odds (OR=1.7) of reporting no in-home cannabis smoking.

In-Home Cannabis Smoking Among a Cannabis-Using Convenience Sample from the Global Drug Survey: With Weighted Estimates for U.S. Respondents.

Tripathi, Osika · 2024

Among international cannabis users, any in-home smoking was reported by 63.9% of men, 61.9% of women, and 68.6% of nonbinary people.

Sex- and age-specific respiratory alterations induced by prenatal exposure to the cannabinoid receptor agonist WIN 55,212-2 in rats.

Patrone, Luis Gustavo A · 2023

Prenatal WIN55,212-2 caused greater CO2 sensitivity at most ages in males and juvenile females.

Cannabis use in the intensive care setting: A scoping review.

Renger, Laura · 2023

Cannabis-associated ICU admissions were primarily from vaping-associated lung injury (EVALI) and synthetic cannabinoid toxicity.

Effects of Smoking Marijuana on the Respiratory System: A Systematic Review.

Vásconez-González, Jorge · 2023

Marijuana smoking exposes lungs to combustion byproducts that cause airway inflammation, chronic bronchitis symptoms, and possible emphysematous changes.

Associations for subgroups of E-cigarette, cigarette, and cannabis use with asthma in a population sample of California adolescents.

Williams, Rebecca J · 2023

Each substance (e-cigarettes, combustible cigarettes, and cannabis) was independently associated with asthma among California adolescents.

In-home cannabis smoking more prevalent than in-home tobacco smoking among 2019 Global Drug Survey respondents.

Bellettiere, John · 2022

Among cannabis-only users, 78.8% reported past-year in-home cannabis smoking, compared to 67.9% of tobacco-only users smoking tobacco at home.

Are vaporizers a lower-risk alternative to smoking cannabis?

Chaiton, Michael · 2022

Cannabis vaporizers reduce carbon monoxide emission, chronic respiratory symptoms, and exposure to several toxins while producing similar subjective effects and blood THC concentrations compared to smoking.

Prevalence and factors associated with self-reported exposure to secondhand cannabis smoke in the United States and Canada in 2019.

Driezen, Pete · 2022

Monthly secondhand cannabis smoke exposure at home was reported by 16.9% in Canada, 20.6% in U.S.

Association between secondhand marijuana smoke and respiratory infections in children.

Johnson, Adam B · 2022

Caregivers who used marijuana reported an increased rate of viral respiratory infections in their children (1.31 episodes/year) compared to non-users (1.04 episodes/year, p=0.02).

Marijuana and the Lung: Evolving Understandings.

Joshi, Manish · 2022

Marijuana can cause bronchitis symptoms.

Characteristics of Adults Who Use Both Marijuana and E-Cigarette, or Vaping, Products: A Cross-Sectional Study, Utah, 2018.

Lewis, Nathaniel M · 2022

Dual users of marijuana and e-cigarettes had dramatically higher odds of being aged 18-29 (aOR 12.44), being male (aOR 3.29), reporting 14+ days of poor mental health (aOR 2.30), having asthma (aOR 2.09), COPD (aOR 2.94), currently smoking cigarettes (aOR 4.56), and using prescribed pain medications (aOR 2.13)..

Measuring PM2.5 concentrations from secondhand tobacco vs. marijuana smoke in 9 rooms of a detached 2-story house.

Ott, Wayne R · 2022

A marijuana joint produced average 5-hour PM2.5 concentrations of 38.9-80.7 mcg/m3 across three experiments, compared to 15.0-15.2 mcg/m3 for a tobacco cigarette.

Inhaled Marijuana and the Lung.

Tashkin, Donald P · 2022

Smoking marijuana produces short-term bronchodilation in healthy subjects and asthmatics.

Disparities in Marijuana and Tobacco Smoke Incursions Among New York City Families During Early Months of the COVID-19 Pandemic.

Zajac, Lauren · 2022

Marijuana smoke incursions were reported by 30.7% of surveyed families.

Cannabis use disorder and the lungs.

Gracie, Kathryn · 2021

Cannabis smoking causes bronchitis and increases central airway resistance with lung hyperinflation and higher vital capacity.

Trends in Prevalence and Outcomes of Cannabis Use Among Chronic Obstructive Pulmonary Disease Hospitalizations: A Nationwide Population-Based Study 2005-2014.

Gunasekaran, Kulothungan · 2021

Of 6,073,862 COPD hospitalizations, 24,546 (0.4%) had concurrent cannabis use.

Reported Marijuana and Tobacco Smoke Incursions Among Families Living in Multiunit Housing in New York City.

Sangmo, Lodoe · 2021

Among 382 surveyed families, 30.9% reported marijuana smoke incursions while home with their child, with NYCHA (public housing) residents 3.45 times more likely to report exposure compared to other housing types..

E-cigarette or vaping product use-associated lung injury.

Ind, Philip W · 2020

EVALI presented primarily in young men as severe lung consolidation with respiratory failure.

Cannabis, e-cigarettes and anesthesia.

Lynn, Rachael S Rzasa · 2020

Cannabis use may reduce the efficacy of propofol and postoperative opioid pain management, potentially requiring higher doses.

Self-reported exposure to, perceptions about, and attitudes about public marijuana smoking among US adults, 2018.

Schauer, Gillian L · 2020

Among 4,088 US adults surveyed in 2018, 27.4% reported marijuana secondhand smoke (SHS) exposure in the past week in indoor and/or outdoor public areas.

Quantitative biochemical screening for marijuana use and concordance with tobacco use in urban adolescents.

Benowitz, Neal · 2019

The standard immunoassay substantially underestimated THC exposure compared to high-sensitivity chromatographic testing.

Cannabis-Associated Asthma and Allergies.

Chatkin, J M · 2019

Multiple studies associate marijuana use with increased asthma symptoms and other allergic disease manifestations, as well as increased frequency of medical visits.

Prevalence of Involuntary Environmental Cannabis and Tobacco Smoke Exposure in Multi-Unit Housing.

Chu, Alanna K · 2019

Among multi-unit housing residents in Ontario, 7.5% reported environmental cannabis smoke (ECS) exposure and 6.6% reported environmental tobacco smoke (ETS) exposure from neighboring units.

E-cigarette Use, or Vaping, Practices and Characteristics Among Persons with Associated Lung Injury - Utah, April-October 2019.

Lewis, Nathaniel · 2019

92% of interviewed patients reported using THC-containing products, 66% used nicotine products, and 60% used both.

Cannabis Associated "High" Cardiovascular Morbidity and Mortality: Marijuana Smoke Like Tobacco Smoke? A Déjà Vu/Déjà Vécu Story?

Manolis, Theodora A · 2019

Despite different active ingredients (THC vs nicotine), cannabis and tobacco smoke contain largely identical combustion chemicals.

Cannabis Inhalation and Voice Disorders: A Systematic Review.

Meehan-Atrash, Jiries · 2019

The only laryngeal study found dark vocal folds in cannabis smokers.

The effects of marijuana smoking on lung function in older people.

Tan, Wan C · 2019

Among heavy marijuana users, the risk of COPD was significantly increased (adjusted OR 2.45, 95% CI 1.55-3.88).

Pulmonary effects of inhaled cannabis smoke.

Tashkin, Donald P · 2019

Cannabis smoking topography (deeper inhalation, longer breath-holding) results in higher per-puff exposures to tar and gases compared to tobacco.

Regular cannabis use, with and without tobacco co-use, is associated with respiratory disease.

Winhusen, Theresa · 2019

Regular cannabis use was associated with increased risk of asthma (OR 1.32-1.50), COPD (OR 1.44-2.17), and pneumonia (OR 1.80-2.13) across all groups.

Effect of Vaporized Cannabis on Exertional Breathlessness and Exercise Endurance in Advanced Chronic Obstructive Pulmonary Disease. A Randomized Controlled Trial.

Abdallah, Sara J · 2018

Despite decades-old studies showing that smoked cannabis can act as a bronchodilator in healthy people and those with asthma, this randomized controlled trial found no such benefit in people with advanced COPD. Sixteen adults with severe COPD (average lung function at 36% of predicted normal) inhaled vaporized cannabis containing 18.2% THC or a control.

Cannabis Use, Lung Cancer, and Related Issues.

Jett, James · 2018

Researchers reviewed the evidence on cannabis, lung cancer risk, and therapeutic applications in oncology. On lung cancer risk: smoking cannabis has not been proven to be a risk factor for lung cancer development.

Trends of Cannabis Use Disorder in the Inpatient: 2002 to 2011.

Charilaou, Paris · 2017

Among nearly 2.8 million hospital admissions with documented cannabis abuse/dependence (0.91% of all admissions), prevalence increased from 0.52% to 1.34% over the decade.

Lung Disease Associated With Marijuana Use.

Chatkin, José Miguel · 2017

The review established that marijuana smoke and tobacco smoke share many of the same combustion byproducts, including carcinogens and respiratory irritants.

Health effects of exposure to second- and third-hand marijuana smoke: a systematic review.

Holitzki, Hannah · 2017

This systematic review examined 15 studies on the health effects of secondhand marijuana smoke exposure, finding three consistent outcomes. First, exposure to secondhand marijuana smoke produces detectable levels of cannabinoid metabolites (THC breakdown products) in the blood and urine of non-smokers.

Cannabis: Exercise performance and sport. A systematic review.

Kennedy, Michael C · 2017

This systematic review searched for all published studies investigating THC's effects during formal exercise protocols, finding only 15 studies in the entire literature. None of the 15 studies showed any improvement in aerobic exercise performance from THC.

E-cigarette use and asthma in a multiethnic sample of adolescents.

Schweitzer, Rebecca J · 2017

In a statewide survey of 6,089 high school students in Hawaii (mean age 15.8), current e-cigarette use was significantly associated with currently having asthma (adjusted OR = 1.48) and with previously having asthma (aOR = 1.22). Notably, after controlling for e-cigarette use and demographic factors, neither cigarette smoking nor marijuana use were significantly associated with asthma in the multivariate analysis.

Patterns of marijuana and tobacco use associated with suboptimal self-rated health among US adult ever users of marijuana.

Tsai, James · 2017

Using nationally representative NHANES data (2009-2012) from 3,210 adults who had used marijuana at least once, researchers examined how patterns of marijuana and tobacco co-use related to self-rated health. Among ever marijuana users, 24.7% were regular marijuana smokers who also currently used tobacco, 21.1% were regular marijuana smokers without tobacco, and 15.2% were non-regular marijuana smokers with tobacco. Compared to non-regular marijuana users without tobacco (the reference group), the adjusted prevalence ratios for reporting "fair" or "poor" health were: regular marijuana + tobacco: 1.98 (nearly double the odds), non-regular marijuana + tobacco: 1.82, and regular marijuana without tobacco: 1.34. Tobacco use was the dominant driver of worse self-rated health, but regular marijuana use alone was also significantly associated with suboptimal health status..

A Systematic Review of the Respiratory Effects of Inhalational Marijuana.

Martinasek, Mary P · 2016

This systematic review compiled 48 studies on the respiratory effects of smoking marijuana.

Effect of cannabis smoking on lung function and respiratory symptoms: a structured literature review.

Ribeiro, Luis Ig · 2016

This structured literature review found a surprising divergence between cannabis and tobacco effects on lung function.

One Minute of Marijuana Secondhand Smoke Exposure Substantially Impairs Vascular Endothelial Function.

Wang, Xiaoyin · 2016

Researchers exposed rats to marijuana secondhand smoke at levels comparable to real-world tobacco secondhand smoke conditions and measured blood vessel function using femoral artery flow-mediated dilation (FMD), a standard measure of endothelial health. Just one minute of marijuana smoke exposure impaired FMD to a comparable extent as tobacco smoke.

Urinary concentrations of PAH and VOC metabolites in marijuana users.

Wei, Binnian · 2016

Researchers analyzed urinary biomarkers of combustion by-products in participants from the National Health and Nutrition Examination Surveys (2005-2012), comparing self-reported recent marijuana users with non-users while carefully controlling for tobacco smoke exposure. Exclusive marijuana users (no tobacco) had significantly elevated levels of multiple monohydroxy polycyclic aromatic hydrocarbons (OH-PAHs) compared to non-users.

Damaging Effects of Cannabis Use on the Lungs.

Yayan, Josef · 2016

This review examined the pulmonary effects of cannabis smoking.

Butane Hash Oil Burns Associated with Marijuana Liberalization in Colorado.

Bell, Cameron · 2015

Researchers documented all hydrocarbon burns related to butane hash oil (BHO) extraction admitted to a Colorado burn center from 2008 through 2014.

The effects of marijuana exposure on expiratory airflow. A study of adults who participated in the U.S. National Health and Nutrition Examination Study.

Kempker, Jordan A · 2015

Researchers analyzed lung function data from over 100,000 U.S.

Cannabis, tobacco smoking, and lung function: a cross-sectional observational study in a general practice population.

Macleod, John · 2015

Researchers recruited 500 people from a Scottish general practice: some smoked only tobacco, others smoked both tobacco and cannabis (predominantly resin mixed with tobacco).

Marijuana and lung diseases.

Joshi, Manish · 2014

This review examined the respiratory effects of inhaling marijuana smoke.

Marijuana: respiratory tract effects.

Owen, Kelly P · 2014

The review found that marijuana smoke produces respiratory symptoms similar to tobacco: increased cough, sputum production, hyperinflation, and upper lobe emphysematous changes.

Adverse effects of cannabis.

· 2011

This comprehensive review examined multiple categories of cannabis adverse effects using systematic methodology. Acute effects included mental slowness, impaired reaction times, and occasionally heightened anxiety.

Effects of smoking cannabis on lung function.

Lee, Marcus H S · 2011

The review noted that despite cannabis being the most widely used illicit drug, respiratory effects were surprisingly under-researched.

Cannabis and the lung.

Reid, P T · 2010

The review examined evidence on respiratory effects of cannabis smoking, noting that mental health concerns had dominated cannabis research while lung effects received relatively little attention. The authors found emerging concern that habitual cannabis smoking may contribute to chronic obstructive pulmonary disease (COPD), pneumothorax (collapsed lung), and respiratory infections including tuberculosis. Regarding lung cancer, the review noted that biological plausibility existed for an association (cannabis smoke contains carcinogens and causes cellular changes), even though epidemiological evidence had not yet definitively established the link.

Cannabis, tobacco and domestic fumes intake are associated with nasopharyngeal carcinoma in North Africa.

Feng, B-J · 2009

Researchers interviewed 636 nasopharyngeal carcinoma (NPC) patients and 615 matched controls across Algeria, Morocco, and Tunisia. Cigarette smoking and snuff were associated with differentiated NPC but not with undifferentiated carcinoma (UCNT), the dominant type in these populations. Marijuana smoking significantly elevated NPC risk independently of cigarette smoking.

Cannabis smoking and risk of lung cancer in men: a pooled analysis of three studies in Maghreb.

Berthiller, Julien · 2008

Researchers pooled data from three hospital-based studies in Tunisia, Morocco, and Algeria, regions with high cannabis consumption. Among 430 male lung cancer cases, 15.3% had ever smoked cannabis, compared to 5% of 778 controls.

A comparison of mainstream and sidestream marijuana and tobacco cigarette smoke produced under two machine smoking conditions.

Moir, David · 2008

Researchers prepared marijuana and tobacco cigarettes identically and analyzed their smoke under two standardized smoking conditions, comparing both mainstream (inhaled) and sidestream (environmental) smoke. Mainstream marijuana smoke contained ammonia at levels up to 20-fold higher than tobacco.

Smoked marijuana as a cause of lung injury.

Tashkin, D P · 2005

This review by a leading pulmonologist examined the lung effects of marijuana smoking.

Mechanisms for impaired effector function in alveolar macrophages from marijuana and cocaine smokers.

Roth, Michael D · 2004

Alveolar macrophages (lung immune cells) from marijuana smokers showed limited antimicrobial activity against Staphylococcus aureus compared to nonsmokers and tobacco smokers.

Medicinal use of cannabis: history and current status.

Kalant, H · 2001

THC and several analogues showed significant therapeutic benefits for nausea, vomiting, and appetite stimulation in patients with wasting syndrome.

Marijuana. Respiratory tract effects.

Van Hoozen, B E · 1997

This review consolidated the evidence on marijuana's effects on the respiratory system, drawing careful comparisons with tobacco. Daily marijuana smoking clearly produced bronchitis symptoms (cough, wheeze, sputum) similar to tobacco smoking, along with measurable declines in pulmonary function.

Health aspects of cannabis.

Hollister, L E · 1986

This extensive review examined cannabis health effects across virtually every organ system and population group. The review's central concern was youth: regular cannabis use might stunt emotional growth in adolescents, though whether the drug caused these effects or whether at-risk youth were drawn to use remained unclear.

Cannabis, 1977.

· 1978

This review synthesized the state of cannabis science as of 1977, covering both therapeutic potential and health concerns. On the therapeutic side, cannabis showed promise for reducing eye pressure in glaucoma and for bronchodilation in asthma.

Health impacts of cannabis: focus on smoking vs. vaping effects on the respiratory and cardiovascular systems.

Chaiton, Michael · 2026

As cannabis legalization shifts consumption patterns toward vaping, this review compares what we know about the health effects of the two main inhalation methods. The good news for vaping: it reduces exposure to the combustion byproducts (tar, carbon monoxide, polyaromatic hydrocarbons) that make smoking harmful.

Cannabis vaping elicits transcriptomic and metabolomic changes involved in inflammatory, oxidative stress, and cancer pathways in human bronchial epithelial cells.

Arlen, Maddison T · 2025

The shift from smoking to vaping cannabis is driven largely by the belief that vaping is safer.

Evaluating the use and perceptions of cannabis and vaping post-cannabis legalisation in people with cystic fibrosis and CFTR-related disorder: survey results from a large Canadian adult cystic fibrosis clinic.

Dagenais, Renee · 2025

43% identified as current cannabis users.

Cannabis User Perceptions: General and Oral Health Benefits and Harms of Vaping Versus Smoking.

Fisher, Jennifer M · 2025

Among 302 current cannabis users, the most commonly reported health benefit of vaping was better pain management (72.5%).

In Vitro Exposure to Vaped Tetrahydrocannabinol Increases Candida albicans (SC5314) Growth, Metabolic Activity, Biofilm Formation, and the Expression of Virulence Genes.

Laaboudi, Fatima-Zahrae · 2025

E-cigarette aerosol with THC increased C.

A cannabinoid receptor 1 inverse agonist induces weight loss and reduces airway hyperresponsiveness in a mouse model of obese asthma.

Morris, Carolyn R · 2025

The CB1R inverse agonist INV-202 produced 11% weight loss in lean and 27% in obese mice.

Work-Related Asthma in the Cannabis Industry: Findings From California, Massachusetts, Michigan, and Washington.

Pacheco, Michelle · 2025

Of 30 work-related asthma cases in the cannabis industry, 52% were new-onset asthma and 48% were work-aggravated asthma.

Cannabinoids and alcohol co-exposure modulate pathogen-induced pulmonary immune responses.

Parker, De'Jana · 2025

Adolescent cannabinoid exposure primed mouse lungs for more severe inflammation when later infected with Klebsiella pneumoniae.

Prenatal cannabinoid exposure affects central cardiorespiratory control in young male and female rats.

Patrone, Luis Gustavo A · 2025

Prenatal cannabinoid exposure (WIN 55,212-2) caused lasting impairments in cardiorespiratory control in juvenile rats.

Effects of maternal edible THC consumption on offspring lung growth and function in a rhesus macaque model.

Shorey-Kendrick, Lyndsey E · 2025

THC-exposed infant macaques had significantly reduced forced residual capacity, along with decreased total lung capacity, lung diffusion capacity, and lower fetal lung perfusion on prenatal MRI.

Cannabis cigarette smoking disrupts mice multi-organ bioactive lipid metabolism and inflammation-resolution signaling in an obesogenic setting.

Upadhyay, Gunjan · 2025

Cannabis smoke weakened cardiac GLS.

Transcriptomic changes in oxidative stress, immunity, and cancer pathways caused by cannabis vapor on alveolar epithelial cells.

Wilson, Emily T · 2025

Many people switch from smoking to vaping cannabis believing it's safer.

Impact of Marijuana Use on Lung Health.

Bando, Joanne M · 2024

This is one of the central paradoxes in cannabis research: smoked marijuana produces many of the same toxins and carcinogens as tobacco smoke, yet the lung health consequences appear markedly different. The consistent finding across studies is that regular marijuana smoking causes symptoms of chronic bronchitis — cough, increased sputum production, wheezing — and visible changes to airway tissue (histopathologic changes in the epithelium).

From Euphoria to Emergency: Exploring the Role of K2/Spice in Diffuse Alveolar Hemorrhage.

Allena, Nishant · 2023

The patient presented with hemoptysis (coughing up blood) after smoking K2/Spice.

PM2.5 exposure to marijuana smoke on golf courses and other public outdoor locations: A pilot observational study.

Cheng, Kai-Chung · 2023

Across 24 visits to 10 golf courses, over 20% of visits encountered marijuana smoke, with peak PM2.5 exposures reaching 149 micrograms per cubic meter.

Modulation of pulmonary immune function by inhaled cannabis products and consequences for lung disease.

Preteroti, Matthew · 2023

Cannabinoids interact with the endocannabinoid system to generally dampen immune function in the lungs, including reducing inflammatory responses of epithelial cells and alveolar macrophages.

Vaping additives cannabinoid oil and vitamin E acetate adhere to and damage the human airway epithelium.

Reidel, Boris · 2023

CBD oil exposure caused dramatically increased cell death after 3 days, and this effect was even higher with CBD + vitamin E acetate (VEA) combined.

Pneumomediastinum and Pneumorrhachis Associated With Cannabinoid Hyperemesis Syndrome.

Hernandez Garcia, Laura R · 2022

This is the third reported case of CHS with associated pneumomediastinum and the first documented case of pneumorrhachis (air in the spinal canal) linked to CHS.

Fine Particulate Matter Exposure From Secondhand Cannabis Bong Smoking.

Nguyen, Patton Khuu · 2022

The study quantified PM2.5 levels from secondhand cannabis bong smoke in a residential setting, demonstrating that bystanders are exposed to fine particulate matter during social smoking sessions..

Development and validation of a mouse model of contemporary cannabis smoke exposure.

Fantauzzi, Matthew F · 2021

Cannabis smoke exposure increased airway and lung tissue macrophage populations (tissue-resident alveolar, monocyte-derived alveolar, and interstitial subtypes) in both sexes.

Chronic cannabis smoking-enriched oral pathobiont drives behavioral changes, macrophage infiltration, and increases β-amyloid protein production in the brain.

Luo, Zhenwu · 2021

Cannabis smokers showed oral microbial dysbiosis with increased Streptococcus and Actinomyces and decreased Neisseria.

Vanishing lung syndrome: a consequence of mixed tobacco and marijuana use.

Salley, Jordan R · 2021

This case report describes a patient with long-term dual tobacco and cannabis use who developed idiopathic giant bullous emphysema (vanishing lung syndrome), supporting the hypothesis that combined use may have an additive damaging effect on lung tissue..

Secondhand marijuana exposure in a convenience sample of young children in New York City.

Sangmo, Lodoe · 2021

Among 53 children aged 0-3 years, 20.8% had detectable urinary COOH-THC (a marijuana metabolite), and children with high tobacco smoke exposure were significantly more likely to test positive (p<0.01)..

Vaping-associated lung injury caused by inhalation of cannabis oil.

Abeles, Michael · 2020

The case documented severe acute lung injury secondary to inhalation of cannabis oil via a vape pen.

Cannabis Vaping-Induced Acute Pulmonary Toxicity: Case Series and Review of Literature.

Adapa, Sreedhar · 2020

Literature review identified cases of acute respiratory failure from vaping cannabis oil.

Self-reported Secondhand Marijuana Smoke (SHMS) Exposure in Two New York City (NYC) Subsidized Housing Settings, 2018: NYC Housing Authority and Lower-Income Private Sector Buildings.

Anastasiou, Elle · 2020

67% of residents reported smelling marijuana smoke in their home over the past year, compared to 60% for cigarette smoke.

Acute eosinophilic pneumonia associated with non-cigarette smoking products: a systematic review.

Chaaban, Toufic · 2020

Twelve cases were identified: 5 from marijuana, 2 from waterpipe, 2 from e-cigarettes, 2 from heat-not-burn cigarettes, and 1 from synthetic cannabinoids.

Vaping-Associated Acute Respiratory Failure Due to Acute Lipoid Pneumonia.

Dicpinigaitis, Peter V · 2020

A healthy 28-year-old developed acute respiratory failure 2 weeks after using a street-purchased THC vape cartridge.

Cannabidiol (CBD) modulation of apelin in acute respiratory distress syndrome.

Salles, Évila Lopes · 2020

Using intranasal Poly(I:C) to mimic viral ARDS in mice, researchers found that ARDS significantly decreased apelin expression in blood and lung tissue.

Transcriptomic and barrier responses of human airway epithelial cells exposed to cannabis smoke.

Aguiar, Jennifer A · 2019

Cannabis smoke induced gene expression profiles that overlapped significantly with tobacco smoke, including DNA replication stress, oxidative stress responses, impaired epithelial barrier function, suppressed antiviral pathways, and increased inflammatory mediator production..

Delayed Intracerebral Hemorrhage after Synthetic Cannabis (Bonsai) Abuse; Case Report and Literature Review.

Aydin, Gülçin · 2019

The patient initially presented with dyspnea, hemoptysis, and agitation after synthetic cannabinoid ("Bonsai") use.

Indoor cannabis smoke and children's health.

Posis, Alexander · 2019

Homes with indoor cannabis smoking had higher air particle concentrations than those with cigarette smoking alone (3,131 vs.

Surface Detection of THC Attributable to Vaporizer Use in the Indoor Environment.

Sempio, Cristina · 2019

THC was detected on 6 of 15 surface samples collected from a room where cannabis was vaporized, at quantifiable levels of 348-4,882 ng/m2.

The Social Context of Adolescent Co-Use of Cigarillos and Marijuana Blunts.

Antognoli, Elizabeth · 2018

Researchers conducted in-depth interviews with 30 adolescents aged 14 to 18 who smoked at least one cigarillo per week.

Marijuana smoke induces severe pulmonary hyperresponsiveness, inflammation, and emphysema in a predictive mouse model not via CB1 receptor activation.

Helyes, Z · 2017

This study provided the first systematic, head-to-head comparison of marijuana and tobacco smoke effects on mouse lungs over four months of daily exposure. Marijuana inhalation triggered severe bronchial hyperreactivity within just one week.

Detecting biomarkers of secondhand marijuana smoke in young children.

Wilson, Karen M · 2017

Researchers tested urine from 43 young children (ages 1 month to 2 years) hospitalized with bronchiolitis in Colorado for marijuana metabolites using highly sensitive LC/MS/MS testing. 16% of samples were positive for COOH-THC (the primary marijuana metabolite), with concentrations ranging from 0.03 to 1.5 ng/mL.

Allowing cigarette or marijuana smoking in the home and car: prevalence and correlates in a young adult sample.

Padilla, Mabel · 2015

Researchers surveyed 2,002 students at two southeastern U.S.

How beneficial is vaping cannabis to respiratory health compared to smoking?

Tashkin, Donald P · 2015

This commentary examined whether vaporizing cannabis provides meaningful respiratory health advantages over smoking it.

Cannabidiol, a non-psychotropic plant-derived cannabinoid, decreases inflammation in a murine model of acute lung injury: role for the adenosine A(2A) receptor.

Ribeiro, Alison · 2012

Researchers induced acute lung injury in mice using LPS (a bacterial toxin) and administered a single 20 mg/kg dose of CBD beforehand.

Cannabinoid effects on ventilation and breathlessness: a pilot study of efficacy and safety.

Pickering, Elspeth E · 2011

Nine subjects (five healthy, four with COPD) received sublingual cannabis extract or placebo in a crossover design.

Possible risk of invasive pulmonary aspergillosis with marijuana use during chemotherapy for small cell lung cancer.

Sutton, S · 1986

A patient with small cell lung cancer was using illegally obtained marijuana to control nausea during combination chemotherapy.

Depressant effect of marihuana smoke on antibactericidal activity of pulmonary alveolar macrophages.

Huber, G L · 1975

Lung immune cells (alveolar macrophages) harvested from rats were exposed to marijuana smoke at increasing doses and then challenged with Staphylococcus bacteria.

Relationship between hospitalization from cannabis usage and pulmonary tuberculosis in Thailand from 2017 to 2022.

Chumchuen, Kemmapon · 2024

Cannabis-related admissions increased while TB admissions declined during 2017-2022.

Spontaneous secondary pneumothorax due to cannabis-induced bullous lung disease: a case report.

Zhitny, Vladislav Pavlovich · 2023

An adult male with a history of heavy cannabis use developed bullous lung disease (air-filled sacs in the lung tissue) that led to spontaneous secondary pneumothorax.

Association between marijuana exposure and pulmonary function over 20 years

Pletcher MJ · 2012

Moderate cannabis smoking was associated with a slight increase in lung function measures (FEV1 and FVC), while heavy long-term use showed a trend toward decline — a profoundly nonlinear dose-response opposite to tobacco's linear harm..