Cannabis increased the risk of primary spontaneous pneumothorax in tobacco smokers: a case–control study

Abstract

Combined smoking of tobacco and cannabis significantly aggravates the risk of having a primary spontaneous pneumothorax in young men compared to both never smokers and daily smokers.

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

“…The prevalence of cannabis smokers seems to be even higher in patients developing a pneumothorax. In fact, in the study of Olesen, 34.9% of subjects in the pneumothorax group smoked cannabis within the last year versus 11.5% in the whole population [10]. Moreover, in accordance with common observations [1,10], also in our series we found that CaS were young and were mainly males.…”

“…It is well known that tobacco smoking leads to an increased risk of developing pneumothorax [13], but limited information is available on the relationship between cannabis and pneumothorax. In a study on a large sample of young Danish people, Olesen found that subjects who smoked both cannabis and tobacco had a significantly higher risk of having a spontaneous pneumothorax compared to both NS and TS [10]; however, the study was not designed to investigate the clinical features of pneumothorax. The few other studies on this topic focused mainly on emphysematous lesions and the histopathological features of cannabis smokers who developed pneumothorax [17].…”

“…Patients presenting with secondary pneumothorax (e.g. lymphangioleiomyomatosis or catamenial pneumothorax) or older than 40 years were excluded, to reduce bias from unacknowledged underlying diseases and because previous studies showed that PSP rarely occurs in patients older than 40 years (10). Of course, the presence of bullae or others emphysematous changes at CT-scan were not considered among the diseases determining the exclusion from the study.…”

“…Some respiratory consequences have been documented, such as chronic obstructive pulmonary disease symptoms [5,6] and bullous emphysema [7,8]. There are few studies on the association between cannabis smoking and spontaneous pneumothorax and a relationship is less clear, although a causative link has been suggested [7,9,10,11]. Most studies on this topic are case reports or small case-series, which mainly investigated the correlations between lung emphysema and pneumothorax.…”

“…The comparison of respiratory effects between cannabis and tobacco smoking is also a topic of interest. Some authors have suggested an additive effect of tobacco as a cause of lung damage or pneumothorax in cannabis smokers [10,12]. This suggestion is reasonable, given that tobacco smoking increases the risk of pneumothorax up to 20-fold, in a dose-dependent manner [13].…”