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

Abstract

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

ASRA Pain Medicine consensus guidelines on the management of the perioperative patient on cannabis and cannabinoids

“…216 217 Cannabis smoking has also been associated with pneumothorax, 218 and combining cannabis use with tobacco use may increase this risk. 219 However, in general, cannabis use does not appear to be associated with emphysema. 103 205 213…”

Recurrent Spontaneous Pneumothorax Associated With Marijuana Abuse: Case Report and Literature Review

“…A prospective study supports the correlation between marijuana abuse and primary spontaneous pneumothorax [10]. A case-controlled study by Stefani et al revealed that cannabis smokers are at significant risk of developing bullous lung disease and have a higher incidence of tension pneumothorax compared to both tobacco smokers and nonsmokers [9].…”

“…The harmful pulmonary consequences of chronic marijuana smoking are less well documented than those of tobacco smoking. Spontaneous pneumothorax has been described as a long-term consequence, but most reported cases are of patients who combined tobacco and cannabis, which makes it difficult to see the direct causational effects of long-term marijuana abuse on the lungs [6][7][8][9]. Our patient smokes marijuana heavily without tobacco, which gives us a chance to highlight its effect on the lungs and its potential to cause bullous lung disease leading to spontaneous pneumothorax.…”

Role of Surgical Glue in Persistent Air Leak in Spontaneous Pneumothorax

“…We performed pleural abrasions with resection and application of glue. In our study persistent air leak after surgical intervention was 0% to 10 % without significant in both groups but chest tube removal after operation was range [3][4][5] to [3][4][5][6] days for group A to group B respectively with highly significant p value [0.006].…”

“…Primary spontaneous pneumothorax [PSP] is a condition occurring more commonly in tall, athletic, smoker younger patients usually without underlying lung disease [1][2][3] .…”