Bullous disease of the lung and cannabis smoking: insufficient evidence for a causative link

Tan, Carol; Hatam, Nahid; Treasure, Tom

doi:10.1258/jrsm.99.2.77

Cited by 24 publications

(6 citation statements)

References 25 publications

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“…Cannabis: there is convincing evidence that cannabis causes large airway inflammation, symptoms of bronchitis and increased airway resistance and lung hyperinflation [62][63][64]. However, there is no convincing evidence that long-term pure cannabis use leads to chronic obstructive pulmonary disease (COPD) and emphysema [65]. Nevertheless, there are several case reports of giant lung bullae particularly in the upper lobes among (very heavy) cannabis smokers [66].…”

Section: Lungsmentioning

confidence: 99%

Effects of drug abuse, smoking and alcohol on donor hearts and lungs

et al. 2019

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Potential heart and lung donors with a history of illicit drugs and/or smoking and alcohol are frequently offered, though there is no clear guidance on when it is safe to use these organs. A review of the literature on effects of drugs, alcohol and smoking on donor outcomes, and the effects of these on the intact heart and lung was undertaken. There has been a marked increase in deaths from opioid abuse in many developed countries, though recent evidence suggests that outcomes after cardiothoracic transplantation are equivalent to nonopioid donor causes of death. For donor smoking, there is an increased risk with lung transplantation; however, that risk is less when compared to further waiting on the transplant list for a nonsmoking alternative. Heavy alcohol consumption does not adversely affect heart transplantation, and there is no clear evidence of adverse outcomes after lung transplantation. There are no overall effects of cannabis or cocaine on survival after heart or lung transplantation. In all these cases, careful donor assessment can establish if a particular organ can be used. In most cases, use of drugs requires careful assessment, but is not in of itself a contraindication to cardiothoracic transplantation.

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Section: Lungsmentioning

confidence: 99%

Effects of drug abuse, smoking and alcohol on donor hearts and lungs

et al. 2019

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“…The correlation among cannabis smoking and pneumothorax is still debated. In 2006 a review by Tan and coll., based on 10 patients in four reports, stated that the existing data were unable to confirm a causative link [18]. Since then other case reports, which have been collected in a review by Underner and coll.…”

Section: Plos Onementioning

confidence: 99%

Secondary spontaneous pneumothorax and bullous lung disease in cannabis and tobacco smokers: A case-control study

et al. 2020

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Background The notion that smoking cannabis may damage the respiratory tract has been introduced in recent years but there is still a paucity of studies on this subject. The aim of this study was to investigate the relationship between cannabis smoking, pneumothorax and bullous lung disease in a population of operated patients. Methods and findings We performed a retrospective study on patients operated on for spontaneous pneumothorax. Patients were divided into three groups according to their smoking habit: cannabis smokers, only-tobacco smokers and nonsmokers. Cannabis lifetime exposure was expressed in dose-years (1d/y = 1 gram of cannabis/week for one year). Clinical, radiological and perioperative variables were collected. The variables were analyzed to find associations with smoking habit. The impact of the amount of cannabis consumption was also investigated by ROC curves analysis. Of 112 patients, 39 smoked cannabis, 23 smoked only tobacco and 50 were nonsmokers. Median cannabis consumption was 28 dose/years, median tobacco consumption was 6 pack/ years. Cannabis smokers presented with more severe chronic respiratory symptoms and bullous lung disease and with a higher incidence of tension pneumothorax than both tobacco smokers and nonsmokers. Cannabis smokers also developed a larger pneumothorax, experienced prolonged postoperative stay and demonstrated a higher incidence of pneumothorax recurrence after the operation than nonsmokers did. The risk of occurrence of chronic respiratory symptoms and bullous lung disease in cannabis smokers was dose-related. Conclusions Cannabis smoking seems to increase the risk of suffering from respiratory complaints and can have detrimental effects on lung parenchyma, in a dose-dependent manner. Cannabis smoking also negatively affected the outcome of patients operated for spontaneous

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“…[ 1 ] Smoking is considered as a main risk factor of bullae formation. [ 2 3 4 ] Despite the high prevalence of this disorder, the exact role of bullae in pathogenesis of pneumothorax is still unclear. [ 5 6 ] Lung bullae are categorised into two main groups: bullae within otherwise a normal lung parenchyma which is usually single and bullous formation within an emphysematous lung which are usually multiple.…”

Section: Introductionmentioning

confidence: 99%

“…As mentioned before, affected patients tend to have significant exposure to tobacco smoke. [ 2 3 4 ] Gaensler EA et al . [ 15 ] showed that all their patients with bullous lung disease had a history of smoking and smoke cessation improved lung changes which secondarily contributed to better response to surgery.…”

Section: Introductionmentioning

confidence: 99%

Results of the surgical treatment of pulmonary bleb and bullous disease

et al. 2022

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Objective: Bullous lung disease is characterised by the development of bullae within the lung parenchyma. Smoking is considered as a main risk factor of bullae formation. The clinical manifestation varies from asymptomatic bullae to severe respiratory distress. The exact medical approach is still controversial. Here, we aimed to evaluate the patient clinical characteristics and the indication of surgery in the patients. Methods: This study was an analytic cross-sectional study in Razi hospital, Rasht, Iran, in 2016–2020. A total of 110 patients with newly diagnosed lung bullae underwent evaluation based on a checklist, which assessed the variables as clinical characteristics, bullae features, the medical treatment, and its complication. Eventually, statistical analysis was performed by using SPSS v21.0. Results: A total of 110 patients were enrolled. All the patients were smokers. In 72.9%, the primary presentation was respiratory distress, which needed surgical resection with no recurrence over 8 months. The clinical manifestation varies from asymptomatic bullae in 4.3% and pneumonia in 34.3% to respiratory distress in 61.4%. There was no statistical correlation between clinical manifestation and all the studied variables excluding respiratory distress (p value: 0.659). Seventy patients underwent surgical treatment, in which 20 cases were complicated by air leak that was managed by the chest tube in 16 patients and the Heimlich valve in four patients. No evidence of recurrence was detected. Conclusion: The main risk factor of bulla formation is smoking. Because of various clinical presentations, the appropriate medical approach is of paramount importance.

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Bullous disease of the lung and cannabis smoking: insufficient evidence for a causative link

Cited by 24 publications

References 25 publications

Effects of drug abuse, smoking and alcohol on donor hearts and lungs

Effects of drug abuse, smoking and alcohol on donor hearts and lungs

Secondary spontaneous pneumothorax and bullous lung disease in cannabis and tobacco smokers: A case-control study

Results of the surgical treatment of pulmonary bleb and bullous disease

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