Exactly. Being unable to account for this covariate (tobacco use) pretty much invalidates this analysis. The odds ratio for tobacco use is basically the same (3x).

Also, title needs a 2025.

The physical act of smoking itself is harmful. Not just tobacco specifically, burning and inhaling anything.

Edible forms of cannabis raise heart rate and blood pressure substantially as well.

Also all the bad food choices me and my fellow stoners make when we’re high.

I tried to look up the source article, but there doesn’t seem to be any mention of consumption of edibles versus smoking.

I mean, probably? There's definitely a statistical likelihood of folks who use cannabis also using tobacco products or other substances. It's not a "gateway drug" so much as a "anyone who enjoys thing X is likely to try related things" object. I recall those early studies about alcohol in moderation being good for you eventually being debunked as, "actually, folks who could afford alcohol consistently in moderation also ended up being able to afford health insurance and that created the better outcome"; I suspect there's something similar with cannabis when we look retrospectively, given its illegality for so long (users are less likely to seek medical attention for symptoms or precursors to avoid the stigma).

The thing is we don't know without doing more research, which I genuinely appreciate the authors essentially calling out point blank. They're not saying cannabis is bad, they're saying that looking at the thin amount of valid data we have available thus far, there's definitely a correlation there worth investigating further.

> Nothing is good for you in too great amounts, even water

https://youtube.com/watch?v=XewVicFzRxw&t=152s

Do you smoke?

I’m not from a place where cannabis use was common, but it was present.

Growing up I definitely knew some people who had their demons who turned to drugs.

However we also had a lot of people who were in good situations who picked up drugs for purely recreational reasons. One of my friends at the time even boasted that drugs were actually more appropriate for people like him who were educated, in good situations, and rational (his description of himself) because they knew how to manage themselves and their usage better. He even had links to some subset of the rationality community who had become pro-recreational drugs with a lot of justifications.

His turn to drug use marked the end of his promising academic career. He started struggling with mental health in ways that were obviously related to the drugs. Holding a job had never been a problem until he starting smoking, which marked his turn toward job struggles. His friends and family relationships started declining and falling apart.

He’s not the only one I know like this. The first person I knew who had to go to rehab for drug addiction was a happy, successful guy who started using drugs as a way to party more and for longer. He thought his life was awesome and he was invincible.

I think there’s become a belief that drug use is purely a symptom, but I’ve seen enough people go from happy to falling apart as an obvious result of the drug use. Most of the people I know who started using drugs didn’t do it at their homes in private to cope, they started doing it at parties with friends.

This is even well known with alcohol: There is common belief that being a “social drinker” is a different risk profile than someone who does their drinking alone.

I think it’s a comforting idea that we tell ourselves that nobody chooses to use drugs, they are driven to do so by circumstances out their control. We like removing blame from people and hoisting it on to the world. I don’t think it’s always true, though. Many people use drugs because drugs are rewarding (at first) and they like the way the drugs make them feel. The negative consequences come later.

I have largely stopped smoking because when I smoke regularly I end up weighing 20-30lbs more from eating everything.

Going on an actual calorie restricted diet while consuming cannabis is basically impossible for me.

Then instead of walking 60 minutes I end up sitting and listening to music.

There is really not anything for me that correlates with healthy behavior when I smoke.

> stress, unrest, impending depression, friction with parents

Well, Id guess these are reasons for any case of substance missuse?

this is true of most risk factors though, diet, excercise, relationships, work , all suffer under stress. it's the job of medical reseach to sift this stuff as best they can.

Definitely. The healthy sport academic types stay pretty far away from any kind of mind altering drugs.

Yeah I think for any of the significant pot smokers I've known it's a way of avoiding other issues. As a positive it's probably much better they descend into pot than alcohol which I'm sure many would if it was the only other easy coping mechanism.

In my country, California, we have so much cannabis use and it’s by basically everyone. People with spouse and children, fulfilling careers and exercise regimes. The culture of a place really can change the outcomes. It’s part of why Silicon Valley beat Route 128.

In American collegiate and professional athletic circles almost everyone uses marijuana. I was a nationally ranked junior tennis player and even in that sport almost every other top junior I knew smoked weed.

It was never the healthy sporty types with fulfilling relationships, good grades or a nice career that smoke cannabis heavily (like daily)

^^ many of those are boring people.

FWIW, I've smoked cannabis daily for maybe 15 years, I'm not exactly sedentary (have dogs, a partner and like to (lazily) swim in the sea) but generally don't exercise. Visited a cardiologist like two months ago and have perfectly fine heart despite the smoking.

Anecdotal of course, many could probably bring up counter-stories too, but I do think you bring up a good point, it seems to me a completely sedentary lifestyle seems to be way more destructive to your health than moderate usage of various drugs and/or eating habits. People who just walk a bit daily already seem way healthier and happier than peers in their same age.

That's a very blanket statement, lots of people are in fact prescribed low dose cannabis for anxiety.

I’ve seen it happen over and over again, regular smokers stop smoking because weed only gives them anxiety now. It’s literally a gateway drug to an anxiety disorder.

What strains have you tried?

Excessive THC exposure, not blanket cannabis use, is what’s really being condemned here.

Hemp, meaning very low THC, higher terpene (read as: “essential oils“ and CBD content, is for you (and most!).

You can cold-turkey it. Know daily smokers who (temporarily) quit for multiple reasons, e.g. medical reasons, job, extended travelling.

From what I have seen, there are no side effects at all. They go back to smoking when the opportunity arises, but that's another story.

It's not addictive along the same pathways (as far as I'm aware) from what I observe in my own life you either smoke casually and could stop whenever you want to (I used to then I stopped no problem) or you are dealing with psychological stress factors that are best treated with the help of a mental health professional.

What has worked for me is (1) Buy 4+ boxes of coconut water (2) remove cannabis from your house, (3) drink coconut water whenever you feel like smoking, (4) get some exercise going (swim, push-ups, gym, sports) - whatever the "MVP" of exercise is to start thinking of your body as fit, athletic & strong.

Controlled tapering.

There's more going on here than just the substance's effect.

There's a mind body connection that an altered state can throw into disarray.

Under the influence of cannabis, one may be a lot more aware of physical pain, dehydration, and so on. The key word is aware. Suddenly becoming aware of the fact that you are stressed out, you are carrying tension, can lead to something of a latent processing effect of some of these suppressed or physically felt emotions.

However, if you're generally not tense, ingesting cannabis itself does not always raise the heart rate. I can validate this myself right now, given I wear an Apple Watch and can vaporize cannabis. Looking at my historical data, there is no relationship, and my resting heart rate remains in the 40s.

It's anecdotal, but at the same time we need to be careful with something that acts on the physical, the mental, and dare I say it, the spiritual. If we focus too much on one dimension, we lose the important synergy from processing all dimensions.

Any literature on this or is is just your gut?

>> for the anxiety crowd: don't buy street weed and avoid sativas

I don't think blanket advice like this is helpful. For me indicas increase my anxiety significantly while sativas do the opposite.

I had a similar experience when I was young. Bought a vape and some Cannabis, which probably had really high THC concentration as it tends to have nowadays. Took a bit, didn't feel anything, then took a bit more, and boom, a panic attack. Might even had some hallucinations, I'm not fully sure what was real and what wasn't.

After the experience I felt kind of weird and "slow" for several days. Later I found out that there is also a genetic risk of schizophrenia in my family. No way I'm going to touch anything with THC ever again. I've tried CBD oil though and that was okay, slightly calming effect. But ultimately I prefer beer over that too.

I got one of those off of one hit of some absurd resin moonrock preroll. Not fun

In social systems or spiritual systems where cannabis is used, this is often called "going clear".

We (general West) have no overarching myth or support system to help people navigate this type of pure madness. We have a psychological framework, and anything that interferes with our capacity to construct an I, a me, an ego in real time is seen in the most ultimately negative terms. And the experience is terrifying, such to support these terms.

Though, if through meditation, through religious constructs, or similar, there is a learned capacity to sit with the experience, it is considered less of a breaking and more of a liberation.

Wouldn't recommend it, wouldn't prescribe it. Though this decoupling of self from experience isn't a universal ill.

Anecdotally this isn't uncommon among heavy users, I've heard of similar things happen to a few people. You did the right thing stopping, where people really go off the deep end is when they don't listen to the warning signs and keep blazing.

I think weed should be legal and for the majority of people used in moderation it's going to be fine, but at the end of the day it's a psychoactive drug. It's probably not optimal to use it daily and in particular waking and baking every day is asking for trouble.

Also a case to be made that modern strains are worse. I fully believe that the risk of losing the plot is higher when you're smoking some lemon sherbet bubblegum flavours every day instead of old fashioned moroccan hash

THC increases glutamate release[1], which is most likely the source of this panic. I have psychotic episodes even with a a few big hits but then again I have schizoaffefctive disorder. Glutamate is my arch enemy.

[1] https://link.springer.com/article/10.1186/s42238-025-00277-9

Can relate to this experience. How old were you?

cannabis is harder to quit because it doesn't have that "it's killing you" aspect to it - but staying in bed and playing video games can kill in a different way! Still better than drinking heavily though

One can also use vapes. I avoid the cartridge types as I don't want to guess what was used to process them. Instead I use a simple flower vape which on the face of it should be less bad than say smoking from a joint or bong.

Gummies and other edibles though require processing in the liver before they become active in the body (they are converted to a slightly different form of THC) so you would need to consider whether there are any negative effects on liver health from edibles and then compare to the various 'inhaled' methods.

General friendly advice - for anything not flower, try to get things that are made by live rosin (not resin) as they are the cleanest and should not involve the use of any hydrocarbon solvents for extraction. Live resin would be next, though it does use hydrocarbons. Distilliates which are often in vape cartridges are almost always made with hydrocarbons. While the production method shouldn't matter if everything is done 100% properly, it does require trust that all the butane, etc has been fully removed from the final product.

i researched and experimented with edibles after beign diagnosed with CVD.

i don't beleive edibles are any safer

I wonder if they're doing these studies, finding no significant effect, and just dropping them.

correct. the push for dispensaries has been financial not medical. now that we are getting large scale trials there will be more real evidence to show the public health effects. my guess: it will go the way of smoking eventually. realization around public health effects -> cost of those effects on public services -> taxes and costs go up. I'm curious as to why heart attack and not stroke. seems like bp isn't the only thing at play.

The US government is now in thrall to the Kratom industry though isn't it? No reason to expect any logical consistency from them.

(Literally the person currently responsible for the branch of government that keeps illegal drugs out of the country is an investor in a Kratom company)

The most ridiculous thing about cannabis remaining schedule 1 (high risk of abuse, no known medical use) so long is that there is both prescription THC and CBD. It should have been changed|to a higher (less strict) schedule decades ago with the release of marinol in 1985. Then we could have had a lot more studies being done. Needless to say, not easy to do studies on schedule 1 drugs.

Agree on ROA, but the retrospective cohort study (one of two discussed in this article) did account for many other factors including tobacco use.

I'm not so sure.

There's always been a pragmatic center on cannabis, especially if you're somewhere where it's legalized.

In Canada, we have legal cannabis.

https://www.canada.ca/en/health-canada/services/drugs-medica...

When it was legalized, there was a documentation push and clear presentation of the downsides. In fact, as above, the language is mostly presented in the negative.

This matches the general sentiment of the broad population.

And let's not conflate things. The article is discussing smoked cannabis. This does not invalidate the essential substance and benefit of the experience. If we remove the ingestion method from the basket of effects, it's a different discussion.

Not all positive, yet smoking is clearly not good for you.

Full stop, no matter what it is.

That was likely a reaction to the DARE/reefer madness propaganda many of us grew up with, which was obvious bullshit.

See also: Bitcoin, Tesla/Musk, Apple

> people just want their recreational drugs

Yes, people want to recreate, doing all kinds of activities with various levels of risk. They don't need to concern themselves with whether you can respect it.

Can you respect folks who are treating mental/emotional pain or just physical?

There's a saying: don't throw stones if you live in a glass house. The same human mind that rationalizes the intake of substances is the same one that rationalizes social networks, junk food, eating meat, whatever it is. I wouldn't be so quick to condescend.

At some point in time, it's important to realize that not everyone optimizes for longevity, correctness, rationalism, and so on, and they just simply do what makes them feel good within the limited life that they have.

Nothing is intrinsically harmless. Cannabis can be devastating. But I was just sitting here doing work one day, got a hemorrhage in my eye, and lost half the sight in it. Otherwise, I'm supremely healthy. The cause: a gene.

Or alcohol, or whatever others are doing. In Italy, where I live, people on the ‘left’ side of the political spectrum (let’s say ‘progressives’) tend to think it’s perfectly ok to smoke dope, irregardless of what any scientific study may or may not say. This seems very weird to me.

“They say coke kills but they don’t know when” is a refrain I have heard.

people rarely compare cannabis to fentanyl they normally compare it to alcohol and tobacco...

>but the sumo association does not acknowledge that

That's just wrong. Why do you think their force retirement ages are so low?

Have you ever smoked/ingested cannabis before?

I mean let's face it, most of us reading this comment are medically obese and would probably live at least 2-3 years longer if we lost 20 pounds.

So why don't we?

Before we got Ozempic there was great hope for

https://en.wikipedia.org/wiki/Rimonabant

which blocks the receptor that THC binds to and led to weight loss and further improvements of the “metabolic syndrome” beyond weight loss alone. Unfortunately it caused major depression in some people including suicide.

So looking at it that way it would be no surprise that cannabis causes weight gain and metabolic syndrome and in fact my experience is that if I am using cannabis I get a few kg. I think that is the THC and on top of that if you are smoking you are inhaling small particles that turn your blood into sludge (e.g. your blood is a “complex fluid” with cells in it that can be damaged) and doing damage to your lungs and capillaries and promoting inflammation and all that.

You get the munchies

https://www.youtube.com/watch?v=yN1AQDxwrSg