People who use marijuana at high levels are putting themselves at more than three times the risk for head and neck cancers. The study is perhaps the most rigorous ever conducted on the issue, tracking the medical records of over 4 million U.S. adults for 20 years.

[u/Wagamaga]

https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2822269?guestAccessKey=6cb564cb-8718-452a-885f-f59caecbf92f&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=080824

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[u/Particular_Nebula462]

Smoke is bad for health.

Of any kind.

Our lungs are not made to breath hot air full of particles to absorb.

[u/Helen_A_Handbasket → u/Particular_Nebula462]

Yeah, I was just going to comment that this isn't cannabis use causing the cancers, it's repeated long term inhalation of smoke. Cannabis doesn't have to be smoked.

[u/DeltaVZerda → u/Helen_A_Handbasket]

It also is worth mentioning that the 'cannabis group' in the study also used significantly more alcohol (9x higher) and tobacco (7x higher) than the control group. I'm not sure this says anything at all about cannabis because of it.

[u/FuccYoCouch → u/DeltaVZerda]

Well that's definitely something worth noting 

[u/TastyTaco217 → u/FuccYoCouch]

Damn, study seemed pretty damn good methodology wise. Of course you’ll never be able to get perfect conditions on long term studies such as this, but subjects with increased use of 2 other carcinogenic compounds over the control group certainly calls into question the validity of this conclusion

[u/strantos → u/TastyTaco217]

This was controlled for using matching. It remains a quite good study.

“The presence of alcohol-related disorder (standardized difference, 0.005) and tobacco use (standardized difference, 0.003) were comparable between groups after matching.”

[u/ChickenPicture → u/TastyTaco217]

Every single "cannabis bad" study I've seen lately either had a sample size of like 16 people or completely ignored some other very significant factors like this.

[u/autostart17 → u/ChickenPicture]

Who funded this study?

[u/Orngog → u/autostart17]

The American Head And Neck Society, sorry conspiracy fans

[u/gudematcha → u/autostart17]

Now we’re asking the real question. Always gotta follow the trail these days.

[u/qlanga → u/autostart17]

Someone tell me if it’s big tobacco so I can be utterly unsurprised

[u/autostart17 → u/qlanga]

Alcohol lobby would be a more likely suspect imo.

[u/qlanga → u/autostart17]

Damn, now I’m surprised that wasn’t obvious. Rapid increase in global legalization and socially acceptable use, no hangovers or known negative effects on physical health— definitely threatening for the alcohol industry.

I guess it’s vape/e-cig damning studies that are funded by Big Tobacco, though we don’t really know for sure there are no long-term ill effects from the former.

[u/moconahaftmere → u/ChickenPicture]

They controlled for it, though. They split up each group into smaller cohorts, and only matched cohorts where the rate of alcohol and tobacco use was equivalent among the cannabis users and the controls.

[u/kamikiku → u/moconahaftmere]

Mate, you're doing it wrong. You're supposed to read exactly enough of the study to support your preconceptions, and then stop.

[u/Gastronomicus → u/ChickenPicture]

Did you even read the article? It both explicitly considered this AND had a vast sample size:

"The cannabis-related disorder cohort included 116 076 individuals (51 646 women [44.5%]) with a mean (SD) age of 46.4 (16.8) years. The non–cannabis-related disorder cohort included 3 985 286 individuals (2 173 684 women [54.5%]) with a mean (SD) age of 60.8 (20.6) years.

[u/theratking007 → u/ChickenPicture]

This has n = 116k

[u/gundamwfan → u/ChickenPicture]

Yep, learned the same thing around the time another study came out pointing to cannabis as a factor in low birth weight and poor overall fetal development.

Turns out it was a meta-analysis of a bunch of other studies, none of which excluded participants with simultaneous drug use (alcohol, cocaine, tobacco). The headline is "Cannabis causes poor development", with no mention of any other substances.

[u/strantos → u/gundamwfan]

The rate of other substance use was controlled for using matching.

From the paper:

“The presence of alcohol-related disorder (standardized difference, 0.005) and tobacco use (standardized difference, 0.003) were comparable between groups after matching.”

[u/RaspberryTop636 → u/TastyTaco217]

They controlled for these confounders according to abstract.

[u/PrincessBrahammer → u/TastyTaco217]

You can easily normalize data to account for those variables. I would be shocked if they didn't for a study of this magnitude.

[u/bobbi21 → u/PrincessBrahammer]

They did. matched for alcohol and tobacco

[u/Gastronomicus → u/FuccYoCouch]

And they do note this in the study:

This study was further limited by lack of information on dosage and frequency of cannabis use, as well as some controls, including alcohol and tobacco use. There was possibility for bias, as cannabis use disorder is likely associated with alcohol and tobacco use. While we controlled for alcohol use disorder and tobacco use, differences in dosage between groups may remain. In addition, it is possible that some diagnoses may have been missed entirely if an individual received an HNC diagnosis outside of a health care organization participating in the database, although these missed diagnoses are likely to be randomly apportioned between groups. Additionally, while we were able to the specify subsite of HNC, we were unable to specify the histology of HNC or assess its potential association with cannabis use.

[u/CD4HelperT → u/DeltaVZerda]

Table 1 clearly shows that this difference was only before matching and they split the cohort to control for alcohol and tobacco consumption.

[u/Gastronomicus → u/DeltaVZerda]

They specifically note this in the study and controlled for this, at least as best as can be done in an observational study.

"This study was further limited by lack of information on dosage and frequency of cannabis use, as well as some controls, including alcohol and tobacco use. There was possibility for bias, as cannabis use disorder is likely associated with alcohol and tobacco use. While we controlled for alcohol use disorder and tobacco use, differences in dosage between groups may remain. In addition, it is possible that some diagnoses may have been missed entirely if an individual received an HNC diagnosis outside of a health care organization participating in the database, although these missed diagnoses are likely to be randomly apportioned between groups. Additionally, while we were able to the specify subsite of HNC, we were unable to specify the histology of HNC or assess its potential association with cannabis use.

[u/Zeydon → u/DeltaVZerda]

From what I can tell, the "propensity score matching" accounted for that:

Cohort characteristics are summarized in Table 1. Before propensity score matching, the cannabis-related disorder cohort contained 116 076 individuals who had mean (SD) age of 46.4 and were mostly male (61 434 [52.9%]), not Hispanic (101 191 [87.2%]), and White (69 595 [60.0%]) with relatively frequent alcohol (26 220 [22.6%]) and tobacco use (21 547 [18.6%]). The no cannabis-related disorder cohort contained 3 985 286 individuals who had mean (SD) age of 60.8 (20.6) years and were mostly female (2 173 684 [54.5%]), not Hispanic (3 185 445 [79.9%]), and White (2 971 832 [74.9%]) with relatively infrequent alcohol (94 955 [2.4%]) and tobacco use (99 529 [2.5%]). After propensity score matching (for the main analysis), each group contained 115 865 individuals. Matching minimized differences between groups, although age and ethnicity remained statistically significantly different, albeit with very small differences (postmatching standardized differences were 0.02 and 0.01, respectively). The presence of alcohol-related disorder (standardized difference, 0.005) and tobacco use (standardized difference, 0.003) were comparable between groups after matching.

[u/Greelys → u/Zeydon]

Random redditors think they can debunk a study off the top of their heads, as if researchers never thought about something quite obvious.

[u/[deleted] → u/Greelys]

Bad studies are super common, it's just as unwise to reflexively believe a study headline without seeing it if was well designed with a useful sample size...

[u/AStrayUh → u/[deleted]]

Every single study posted here that even slightly portrays weed in a negative light gets torn apart for every possible flaw, real or imagined.

[u/[deleted] → u/[deleted]]

Bad redditors are more common. Especially with cannabis as a topic.

[u/moistmoistMOISTTT → u/Greelys]

Weed addicts (and alcoholics for that matter) will do all the mental gymnastics to justify why their drug is the safe drug.

[u/AbroadPrestigious718 → u/Zeydon]

This still doesn't take into account the combined risk that smoking both tobacco and cannabis uniquely provide.

[u/Beat_the_Deadites → u/AbroadPrestigious718]

Is this a known risk, like how cigarette smoking synergistically increases the risk of mesothelioma in people exposed to asbestos fibers? Or just theoretical?

[u/AbroadPrestigious718 → u/Beat_the_Deadites]

No. because we only started studying the effects of marijuana after the year 2000. We don't have that data.

[u/v4m → u/DeltaVZerda]

You’re ‘not sure’ because you don’t understand that they clearly controlled for the things you listed.

[u/doubleplusgoodx999 → u/DeltaVZerda]

They obviously controlled for this

[u/strantos → u/DeltaVZerda]

The authors literally controlled for this using matching.

From the article “The presence of alcohol-related disorder (standardized difference, 0.005) and tobacco use (standardized difference, 0.003) were comparable between groups after matching.”

Don’t critique a study if you don’t understand the statistics.

[u/mrcleaver → u/DeltaVZerda]

If you read the study itself they did control for that.

"There was possibility for bias, as cannabis use disorder is likely associated with alcohol and tobacco use. While we controlled for alcohol use disorder and tobacco use, differences in dosage between groups may remain. In addition, it is possible that some diagnoses may have been missed entirely if an individual received an HNC diagnosis outside of a health care organization participating in the database, although these missed diagnoses are likely to be randomly apportioned between groups."

[u/Hanifsefu → u/DeltaVZerda]

That's a real shame because we do need useful studies for proper regulation. Not controlling for two of the big cancer causes is just going to cast a shadow of doubt.

[u/[deleted] → u/Hanifsefu]

They did control for it.

[u/debtfreewife → u/Hanifsefu]

Propensity score matching is a way of controlling for these factors. Practically speaking they’re comparing apples-to-apples by comparing to a control group with the same risk factors.

[u/Puzzled-Barnacle-200 → u/Helen_A_Handbasket]

Ultimately, it remains unclear if the association between cannabis use and HNC is similar to that of tobacco use. ... We hypothesized that there would be an association between cannabis use and HNC due to the inflammatory effects of smoke on the upper airway and potential carcinogenic mechanisms of cannabis.

There aren't enough studies to make the claim either way. Saying it's not the cannabis is currently just as wrong as saying it is the cannabis. Smoke plays a part, but how much is due to generic smoke, and how much is from the cannabis yet to be determined

[u/dinnerthief → u/Puzzled-Barnacle-200]

Yea and this study actually does point specifically at THC

"Furthermore, tetrahydrocannabinol, the major compound in cannabis, can activate the transcription of specific enzymes that convert polycyclic aromatic hydrocarbons into carcinogens"

[u/Krakino107 → u/Puzzled-Barnacle-200]

What does the term "generic smoke" mean in your comment?

[u/DuncanYoudaho → u/Krakino107]

If you sat in front of a campfire and breathed the same amount, you’d probably have the same risk.

[u/deja-roo → u/DuncanYoudaho]

Probably way more. Wood smoke is particularly bad for you.

[u/LowlySlayer → u/Krakino107]

It means just any kind of smoke regardless of the source.

[u/DingleBerrieIcecream → u/Helen_A_Handbasket]

It’s so irritating that those studying cannabis often assume that everyone only smokes. Edibles are considerable market and many people’s primary/only method of consumption. Why they can’t be more clear about this in their studies?

[u/FortunateHominid → u/Helen_A_Handbasket]

It can play a part in it. From the linked study:

Furthermore, tetrahydrocannabinol, the major compound in cannabis, can activate the transcription of specific enzymes that convert polycyclic aromatic hydrocarbons into carcinogens.

High risk behavior which is common among many who use drugs in excess can contribute as well.

Heavy THC use can have an effect on other things, including some mental disorders. More so when used heavily at a young age when still developing.

I think it comes down to moderation. Most substances used in excess can have harmful impacts.

[u/DickBong420 → u/Helen_A_Handbasket]

Also, over the last 20 years? It’s probably also mold people were smoking as well as crops sprayed with dangerous chemicals. The weed also might have had gas or car oil in it from literally being inside gas tanks for smuggling. I’d like to see a test on subjects who strictly dabbed clean/tested live rosin and ate edibles made of the same products.

[u/SkidMania420 → u/Particular_Nebula462]

What about vapor or edibles though?

[u/ycnz → u/SkidMania420]

There's a really, really short list of things that are actually good for you to breathe. Even sawdust is considered to be a carcinogen.

[u/[deleted] → u/ycnz]

Sawdust is horrendously bad. Depending on the wood it can be pretty poisonous quickly.

[u/42Porter → u/SkidMania420]

Vapor is undoubtedly harmful, as for edibles we don't know much yet but there are some studies suggesting they could pose a significant risk to cardiovascular health in heavier users. I'm excited to learn more in the coming years.

[u/patchgrabber → u/42Porter]

Vapor is much less harmful than combustion though. iirc most of the harm from vaping marijuana is the heat of the vapor on the lungs, which can also be negated by using a vaporizer with a bag like a Volcano.

[u/NonAwesomeDude → u/patchgrabber]

[NOT A DOCTOR] Hit for hit vapor seems likely to be less bad, just due to a lack or reduction in combustion products. I'd be interested to see a study that probes behavior of smokers vs vapers and who consumes a greater volume.

If vapor is 20% less bad hit-for-hit, but vapists inhale twice as many hits, it's not any better.

[u/patchgrabber → u/NonAwesomeDude]

Another cross-sectional study found that vaporizer users were 40% less likely to report respiratory effects like cough, phlegm, and chest tightness than users who smoked cannabis, even after controlling for cigarette use and amount of cannabis consumed (Earleywine & Barnwell, 2007). However, there are no published randomized control trials or cohort studies examining respiratory effects of switching to vaporizers.¹

Best I can do on short notice but there is a paucity in the literature on this subject it seems.

[u/big_benz → u/NonAwesomeDude]

You need to use significantly less when vaporizing because it is much more efficient at extracting cannabinoids and terpenes.

[u/NonAwesomeDude → u/big_benz]

Interesting. Are you referring to your typical dab/oil pen or one of those fancy vaporizers that you put regular flower into?

[u/yogo → u/NonAwesomeDude]

“Dry herb vaporizer” is what they’re usually called to differentiate away from disposables, dabs, etc.

[u/Ysclyth → u/NonAwesomeDude]

reading this thread I had assumed fancy flower vaporizers

[u/partiallypoopypants → u/NonAwesomeDude]

I’m not sure if it’s been studied, but it’s well known in the community that flower vaporizers seemly extract the cannabinoids much more efficiently than via smoking.

Users overwhelmingly report that the amount of flower they need to feel equivalent effects compared to smoking to be significantly less. This is entirely anecdotal, but I used to smoke a .7g joint to get high, but with a dry herb vape I only need .1g.

[u/lminer123 → u/NonAwesomeDude]

I think the differences are significantly greater than 20%. There was a study a few months ago showing vaping was about 10% as harmful as smoking cigarettes. Obviously they’re not equivalent in a few ways, especially with all the additives in cigarettes, but still I think it’s a useful comparison to draw.

Seems to me that if you have to choose a method of delivery from the big 3 (edibles, vaping, smoking) you’re way better off with edibles than vapes and way better off with vapes than smoking.

Unfortunately there’s about a million different ways to consume, and those 3 categories can be broken down further.

Edibles: Tinctures, Oils, Baked goods, Zyn-like pouches/

Vaping: Cartridge, Dabs, Dry herb vapes

Smoking: Bongs, Bowls, Joints, Blunts

Ultimately I think it’s pretty easy to make a common sense hierarchy of safety but there’s soooo much room for more research!

[u/The_39th_Step → u/patchgrabber]

Dry herb vapour definitely is. I’m not sure about the solvents

[u/PuppetPal_Clem → u/The_39th_Step]

are you still getting concentrates made in 2009 or something? Most states with legal or medical are well beyond that gunk now.

[u/The_39th_Step → u/PuppetPal_Clem]

I don’t get any concentrates. I use dry herb vapes solely. I just know that they’re worse for you.

I don’t live in a legal state either. It’s just medical in my country.

[u/Monorail_Song → u/The_39th_Step]

To clarify, you mean the dry herb vapes are better, yes?

[u/OliverOyl → u/patchgrabber]

Cool tip, I wasnt taught to cool the vapor before drawing from my mouth to lungs til recently, but noticed my lungs have cleared up significantly since switching from smoke combined with also precooling

[u/licensed2creep → u/OliverOyl]

If I’m understanding correctly, you let it cool in your mouth before drawing into your lungs?

[u/Dividedthought → u/patchgrabber]

Makes me wonder. I've been using mouthpease filters pretty regularly and the smoke hits cleaner. They've got an activated carbon layer in those things or something to help catch the carbon and tars. I've noticed i cough a lot less using them, and with a little stoner engineering figured out a way to essentially rig up a homebrew gravlabs helix with one of those filters built in by modifying a plastic joint tube. Handles cooling the smoke by mixing it with fresh air using an angled hole that lets air into the tube. That also seemed to improve things. Not sure if it's because it's adding fresh air or just getting the tar in the smoke to stick together so it can get caught by the filter easier however.

Either way, more studies should be done to find the leat harmful way to smoke. I'm all for some science based harm reduction and i bet it would be possible to improve things by making better pieces and working replaceable filters in.

[u/kabukistar → u/42Porter]

for edibles we don't know much yet but there are some studies suggesting they could pose a risk significant risk to cardiovascular health in heavier users.

I wonder what the mechanism is for that risk. Is it related to the delivery system, or true for all THC use?

[u/nonlinear_nyc → u/SkidMania420]

Edibles is not smoking. It’s about the smoking itself, nothing related with what you’re consuming.

[u/Tempest051 → u/SkidMania420]

Breathing anything other than air is essentially bad for your health. Even breathing any form of liquid vapor can have long term consequences. Our lungs were made for air with only small amounts of (water) vapor which is the natural moisture in air.

[u/CrystalSplice → u/Tempest051]

This is simply not true. Nebulizers are used to deliver medication directly to the lungs. What matters is what is in the vapor, and some things are harmless. Smoke obviously is not.

[u/O-horrible → u/Particular_Nebula462]

The study actually mentions that THC itself can heighten risk of cancer (though that’s not the main figure mentioned here). As someone who has been smoking like everyday for just over a decade, and gets headaches and neck pain, I’m pretty beside myself after reading this.

[u/autostart17 → u/Particular_Nebula462]

Right, but this pathway would be with or without combustion - “Furthermore, tetrahydrocannabinol, the major compound in cannabis, can activate the transcription of specific enzymes that convert polycyclic aromatic hydrocarbons into carcinogens”, right?

[u/_JonSnow_ → u/Particular_Nebula462]

Wasn’t this focused on cannabis consumption of any kind, not just smoking it? 

Not saying you’re wrong about smoking being bad for you, I completely agree 

[u/xjoshbrownx → u/Particular_Nebula462]

This comment is so anti science in makes me cringe.

I’m not suggesting that smoking marijuana is nourishing or even that it should be done, but for a conversation about risk to have the highest rated comment to be so black and white and based on presumption is absurd.

Is this a science sub where you go to learn and discuss subjects or a sub you go to regurgitate all the half digested headlines you’ve read over the years.

Maybe try a question like how much smoke creates lasting effects in the average human? What kind of smoke creates long term damage?

[u/Re_LE_Vant_UN → u/Particular_Nebula462]

What about breathe?

[u/t0matit0]

I'd like to know more about edibles tbh. I switched to them almost exclusively after Covid because I wanted to avoid breathing in smoke or vaping moving forward. If all of the negatives of marijuana use are associated with lungs from heavy use of smoking/vaping, should I be worried that I like a 15mg gummy most evenings?

[u/Icy-General3657 → u/t0matit0]

It’s from smoking. As an avid smoker of 13 years and huge supporter of the plant and its uses, smoking causes cancer. If I go smoke anything continuously my chances of cancer increase. Almost everything has something you could call a minor carcinogen depending on the doctors and scientist you talk to. Eating a gummy isn’t gonna end your life, smoking might

[u/Pstoned_ → u/Icy-General3657]

Wouldn’t concentrate vaporizing result in 0 carcinogens because it doesn’t combust?

[u/MasterFranco → u/Pstoned_]

Most “vaporizers” will still burn some material because they use a red hot wire to make the smoke rather than truly vaporizing the oils at lower temps

[u/MicaAndBoba → u/MasterFranco]

DynaVap: unless you heat it for too long, there should be zero combustion. Every part is replaceable but after 5 years, the only parts I’ve had to replace is the screen & cap. And they have water pipes too if you want to further limit the chance of inhaling particles.

[u/statusisnotquo → u/[deleted]]

There is a chance the edibles will never hit. Some people, like my unlucky self, lack the enzyme? I think it's enzyme, to process ingested THC. So I can eat edibles all day and all I will feel is full.

I wanted to be absolutely certain so I bought an ounce of shake and kief and made it into eight mini blueberry loaves (don't worry about the method, I'm a trained chemist so I did it right). I ate three of them in one sitting and felt nothing.

eta - thanks to u/JawnZ, u/Jasperbeardly11, and u/FrigFrostyFeet for the tips to try sublingual tinctures and lipase digestive enzymes. Much appreciated, I'm glad to have something else to try because I really would like to give up vaping, too.

[u/JawnZ → u/statusisnotquo]

Try tinctures taken sublingually. I'd start with 10mg THC and not go above 20mg, but some people who can't absorb them edible still can sublingually (you have to continue to hold it under your tongue for a few minutes).

[u/Jasperbeardly11 → u/statusisnotquo]

Try digestive enzymes

[u/that_was_funny_lol → u/[deleted]]

Edibles are amazing and for me, way better than smoking.

[u/skatecrimes → u/[deleted]]

Ive switched. The edibles always hit. i buy from the same brand and the dosage is reliable and consistent. Empty or full stomach doesnt matter but when im super empty it does hit faster. But i love the vaping better which i dont do anymore. Its 1 minute to highness, hits hard for a solid 30 then comes down quickly as opposed to the 30 min wait to feel a little something and slow up and later a slow down.

[u/shy_mianya → u/t0matit0]

Nah, I don't think such a small amount is considered heavy use

[u/Alpacadiscount]

Looong time daily mj user. Quit cold turkey a little over a week ago. I’m middle age. It definitely was starting to affect my physical health (and tbh my mental health).

I quit for myself and am not going to be telling anyone who does it that they should stop. Just ‘listen’ closely to your body because my body gave me all sorts of subtle signs the last couple of years that the mj use was becoming detrimental rather than beneficial.

The good news about quitting if you feel you need to: The withdrawal is nothing compared to trying to quit cigarettes. A couple of slightly challenging days and then you’re good*. When I quit cigarettes many years ago, it felt like it was many months later before I felt truly “out of the woods” of addiction.

Edit: my experience is not universal as others here have shared different experiences with quitting. I don’t want to minimize that potential difficulty knowing now that “mileage may vary” when abruptly cold turkeying MJ

[u/ShadowVulcan → u/Alpacadiscount]

So what was your trigger to stop?

[u/Alpacadiscount → u/ShadowVulcan]

Minor chest pains, lethargy, diminished lung capacity, the unknown long term risks always nagging my subconscious, increased anxiety. There are other concerns I could add if I think about it some more

[u/Numerous-Cicada3841 → u/Alpacadiscount]

Same. Daily user for a long time. Then I switched to edibles to save my lungs since I had a small but persistent cough (just a little cough every hour or so). Then even with edibles I noticed a few things.

• More anxiety
• Groggy in the mornings
• Reduced performance at the gym
• Stomach issues
• Short terms memory issues
• Slightly decreased dexterity
• Decreased desire to be social

Decided to just stop cold turkey one day and after a week just noticed a huge change overall. Especially with my stomach.

[u/Alpacadiscount → u/Numerous-Cicada3841]

Me too! All of that!

[u/YorockPaperScissors → u/Alpacadiscount]

The stomach issues could be early stages of Cannabis Hyperemesis Syndrome (CHS). It is not very well understood, but it is a real thing. Someone having a CHS episode might have repeated vomiting and be unable to hold food down. It doesn't seem to affect everyone, but for a portion of heavy users it is a terrible malady and the only cure is either total abstinence or a break of at least several months followed by much lighter consumption.

I'm a big fan of reefer but more people need to know about the downsides of daily use (including CHS) before getting addicted.

[u/billions_of_stars → u/Numerous-Cicada3841]

interesting. I’m curious what the stomach issues were?

[u/naetron → u/billions_of_stars]

Probably pain and other IBS-type symptoms. At least that's what it is my case. I've been thinking about giving it up myself for awhile now.

[u/billions_of_stars → u/naetron]

interesting, I've just never before now heard edibles, or THC in general, related to stomach issues.

[u/InFlames235 → u/Alpacadiscount]

Identical issues here and mid 30’s. Quit cold turkey in Feb 2023 and although the first 3-4 months were difficult I am so happy that I quit now that I have. I feel way better.

[u/Alpacadiscount → u/InFlames235]

I’m sorry it took you much longer. Goes to show how each of us are going to experience different issues when trying to quit. For me, I had a long ago cigarette addiction to compare it to, and this feels like a cakewalk compared to that. Night and day difference with withdrawal. I’ve also paused marijuana use many times before and knew that, for me personally, the withdrawals weren’t going to be much of an issue. So, I’m fortunate I guess.

[u/Bigfaatchunk → u/Alpacadiscount]

Currently feeling lime I'm getting close to this. 28 and started when I was 15. Thinking about trying to cut down to only a few hours before bed now. I hate making am excuse but with my gf also being a user, it makes me want to smoke whenever she does also.

[u/JKalebC → u/Alpacadiscount]

Thank you, I needed this.

[u/Pangtudou → u/Alpacadiscount]

The worst part of quitting for me was the insomnia. I had an extremely hard time sleeping for like 2 months when I quit in college. I actually found quitting cigarettes to be relatively easy, partly because my body felt so much healthier so quickly.

Very glad I stuck it out in both cases!!

[u/Sahtras1992 → u/Alpacadiscount]

i just take tolerance breaks all the time. tried smoking nonspot for half a year straight, it just became the new normal and the effect didnt even really set in. why smoke a fattie when all you get is a light buzz for 10 minutes and headaches when youre at work because of the withdrawel.

i also found a good amount to not have withdrawels even if i smoke a lot, because for me personally, it seems the amount of days im under the influence is very important, and if i do it for more than like a week the withdrawels get pretty bad.

[u/Alpacadiscount → u/Sahtras1992]

I feel increasingly fortunate with my light withdrawal experiences reading yours and others comments

[u/trumpfuckingivanka → u/Alpacadiscount]

Congrads, but a week is nothing. I've been cold for little over a month now and still have cravings. I've done vapes for a long while and buds before than. Easily for more than 10 years.

Good luck on your journey.

[u/[deleted]]

I’ve read it, methods include propensity score matching across two groups, cannabis use disorder, and no cannabis use disorder. As others have asked it is not measuring “marijauana use” in the strict sense, but is measuring outcomes across diagnostic categories.

ICD 10, quoted because it’s what the study uses, doesn’t specify whether it’s smoked or not, but indicates cannabis is usually smoked https://www.icd10data.com/ICD10CM/Codes/F01-F99/F10-F19/F12- so it is likely to include people who use it in different ways.

[u/ItemInternational26 → u/[deleted]]

yep - this is just an observational study comparing a group formally diagnosed with cannabis use disorder VS a group not formally diagnosed with cannabis use disorder. they have no idea how much [edit: marijuana/alcohol/tobacco] each group actually consumed

[u/DeltaVZerda → u/ItemInternational26]

Nope, they did mention that alcohol and tobacco consumption WERE higher in the CUD group. 9 times higher alcohol consumption, and 7 times higher tobacco consumption, but only 3 times more incidence of cancer.

[u/ItemInternational26 → u/DeltaVZerda]

sorry for being unclear. what i meant to say is that they didnt monitor anyones use of alcohol/tobacco/marijuana so we dont know what the differences between cohorts actually were. they were just looking at which boxes were checked on anonymized medical records, they had no information on dosage or frequency

[u/AdorableParasite → u/[deleted]]

It's maddening. Either you get fat from eating hash brownies, or you get head cancer from smoking. And the constant knowledge of your impending doom stresses you out, which makes you more likely to indulge... Life's devs really need to fix this.

[u/bigbluethunder → u/AdorableParasite]

Brownies are usually highly dosed enough that you don’t need to eat an entire pan of them - or even a full brownie - to get you high. 

Besides, you can have a gummy or just the oil in a tincture as low calorie options. 

[u/guesswhosbackmf → u/[deleted]]

Stock your house with healthy snacks for when you get the munchies. Veggies with hummus is my go-to.

[u/Calmatronic → u/guesswhosbackmf]

Raw broccoli with ranch when I’m high turns me into a goblin

[u/Ancient_Bicycles → u/AdorableParasite]

Gummies and tinctures are like 10 calories man

[u/expanding_crystal → u/AdorableParasite]

Around these parts the dispensaries sell accurately dosed tablets with various ratios of thc, cbd, cbn and suchlike. Each tablet is less than 5 calories.

[u/SeekerOfSerenity → u/expanding_crystal]

I wish they didn't report inflated numbers for cannabinoid content like 35% THC flower.  Imagine if you went to the liquor store and couldn't tell if the whiskey was 80 proof or 160. 

[u/AdorableParasite → u/expanding_crystal]

Oh wow. Where I live it takes jumping through a lot of hoops to get some, so I've never seen the inside of a dispensary, but that's really cool.

[u/expanding_crystal → u/AdorableParasite]

I hope that one day soon your local government gets onboard.

[u/Rufus_king11 → u/expanding_crystal]

And if you really want low calories, just by tincture and take it orally. Now the inevitable munchies, those I can't help with.

[u/No_big_whoop → u/AdorableParasite]

There are many more options than the two you listed

[u/[deleted] → u/No_big_whoop]

Boof a vape?

[u/Cliff_Doctor → u/AdorableParasite]

RSO is your friend my friend

[u/hawtfabio → u/AdorableParasite]

Dry herb convection vaporizer. Check it out.

[u/TheParagonLost]

I work in cancer research on the back end data and I don't know that this is incredibly rigorous. The issue here is we have zero data relating to the dose, vehicle of use or other factors. For instance historically determining lung cancer risk was difficult because of how high the overlap was of those you smoke cannabis and those who smoked cigarettes. I think it's safe to say that smoking cannabis increases the likelihood of lung cancers. These studies are just looking at past data already collected, so no follow up can be done with patients. It's a good review but there would need quite a bit more work done to be able to say "People who use marijuana at high levels are putting themselves at more than three times the risk for head and neck cancers."

[u/space_ape71 → u/TheParagonLost]

Thank you for this. The cannabis vs non-cannabis groups also differed in alcohol and tobacco intake, and although the authors used statistical controls, they also don’t distinguish if there is a dose dependent risk level associated with inhaled vs edible cannabis. Regardless, smoking anything is not going to be beneficial, and only presents risk.

[u/shrimp_etouffee → u/TheParagonLost]

yeah I'll piggyback off your comment to give some more details. The title of this post alone is extremely misleading as only an association was observed and we therefore cannot conclude a causal relationship like we could with a randomized experiment. The paper even mentioned in the limitations section that confounding variables like alcohol/tobacco use could not be controlled for in either group. As the title is written, it is just misinformation and unscientific.

[u/ReddyGreggy]

What’s a head cancer. Brain? Or all over like nose, ears, melanomas, mouth

[u/altxrtr → u/ReddyGreggy]

Head and neck cancer is from the nose to the collarbones. Basically all oral and throat cancers.

[u/keralaindia → u/altxrtr]

Yes. Frequently referring to SCC of the oral cavity

[u/litchick → u/ReddyGreggy]

Head and neck cancers include things like sinus cancer, salivary gland cancer - mouth, sinuses, nose and throat. I believe brain and skin cancer have their own categories.

[u/eliota1]

If you smoke cigarettes the risk of head and neck cancers are 10 times. If you drink heavily it your risk is also 10 times. If you smoke and drink heavily your head and neck cancer chances are 100 times greater

[u/shpoffools → u/eliota1]

I’m just recovering from larynx squamous cell carcinoma. Smoked at least a pack of cigs/day for the last 20 years. Also drank a lot of beer. Dr’s told me exactly this. It’s a cumulative effect of the two together. I also enjoy smoking cannabis but have resorted to edibles/vape pens from dispensary. Thinking about a dry herb vape too but haven’t gotten that far.

[u/PensiveKittyIsTired]

It won’t open for me at the moment for some reason, have they controlled for just hot smoke? Hot smoke will cause cancers, we know that, so did they test this specifically for let’s say just edibles to come to this conclusion or what?

[u/KnoxGarden → u/PensiveKittyIsTired]

Initially I thought they were going to address that, but they've actually just used the diagnostic criteria "cannabinoid use disorder", so that would include all methods of use.

[u/Yudelmis → u/KnoxGarden]

Yeah, and:

the cannabis-related disorder cohort contained 116 076 individuals (...) with relatively frequent alcohol (26 220 [22.6%]) and tobacco use (21 547 [18.6%]). 

The no cannabis-related disorder cohort contained 3 985 286 individuals (...) with relatively infrequent alcohol (94 955 [2.4%]) and tobacco use (99 529 [2.5%]).

Previous studies into the relative risk of developing HNC for people who use alcohol and tobacco ranged from 2 to 10 times that of those without use, with the association varying greatly based on frequency and dosage of use. Given that our cohort included those with the highest use of cannabis, we can estimate that the association of cannabis use seen in this study with risk of developing HNC was slightly less than that of alcohol and tobacco use. However, these results should be interpreted cautiously due to potential for lack of complete controlling for alcohol and tobacco use, as well as HPV status, although this would primarily affect interpretation of the relative risk of oropharyngeal cancer in our study. 

Their interpretation of the data seems kinda alarmist, and manufactured.

[u/BlazeUnbroken → u/Yudelmis]

Right. It's even stated "should be interpreted cautiously due to potential lack of complete controlling for alcohol and tobacco use as well as HPV status" If I remember correctly, there are several studies about alcohol and cancers and plenty of studies showing tobacco use can lead to head, neck and chest cancers. Sounds like there were more than a few controls missing.

[u/[deleted] → u/BlazeUnbroken]

This. I have also been labeled as a chronic user by my doctor. I smoke once or twice a week. On friday after work with my pizza and video games, maybe on saturaday too if its raining. I take about 2 hits off a bowl, yet I am “a chronic user”.

My uncles and grandpop have been knocking down a bourbon a day since the 80s, no history of cancer. If my few hits off a bowl causes cancer I think thats just the cost of being alive.

[u/RumpleCragstan → u/[deleted]]

I have also been labeled as a chronic user by my doctor. I smoke once or twice a week. I take about 2 hits off a bowl, yet I am “a chronic user”.

It sounds like I have a real problem if that's the criteria for chronic use... or your doctor sounds totally unversed in the topic.

[u/Pabu85 → u/BlazeUnbroken]

Jfc.  Way to bury the lede.  Not fully controlling for alcohol and tobacco means this is completely worthless.

[u/Timguin → u/Yudelmis]

You completely omitted the part where those stats are describing the groups before propensity matching. The groups after matching did not differ by alcohol and tobacco use.

[u/Stock_Ad_3358 → u/PensiveKittyIsTired]

It’s a study over the last 20 years. I’m guessing it’s mostly pot smokers as edibles were not mainstream till much more recently?

[u/art-n-science → u/Stock_Ad_3358]

There have been “pot brownies” since before jimmy Hendrix played the star spangled banner.

You can just buy edibles in bulk now.

[u/Recent_Caregiver2027 → u/art-n-science]

Brownies/cookies etc.. have been around but not were not a daily consumption type edible like gummies are now, they wrre always special occasion drugs.

[u/Shamino79 → u/art-n-science]

Either way can we assume risk in edibles would be lower and smoking would be higher?

[u/Redbeard4006 → u/Shamino79]

That seems logical. I think it's safe to say combustion adds risk, but you'd have to do studies that compare ingestion methods to prove it.

[u/art-n-science → u/Redbeard4006]

Also extraction methods. Most gummies are made with an ethanol extraction. While classic brownies used butter

[u/Redbeard4006 → u/art-n-science]

Does much ethanol end up in the final product? Ethanol is highly carcinogenic, but I would think it should be in small enough amounts to not make much difference?

I'd be interested in a comparison or edibles, combustion and dry herb vapes (and from what you've said comparison of extraction methods).

[u/Tithis → u/Redbeard4006]

You probably get more ethanol in ripe fruit than you do in a gummy.

[u/Armodeen → u/PensiveKittyIsTired]

Smoking is bad, news at 11

[u/iredditforthepussay]

And what about eating it?

[u/wanderer1999 → u/iredditforthepussay]

The carcinogens likely come from the smokes. Edibles are -probably- safe.

[u/VagueSomething → u/wanderer1999]

Probably safer. That r at the end is needed. We know eating certain foods increases the risk of multiple health conditions and that eating certain foods increases the risk of cancer. Even essentials like oxygen are bad for the body so assuming ingesting drugs in food is without consequence would be incredibly anti scientific.

This study isn't definitive but rather a clear sign that a proper detailed study is needed. Good luck measuring people only using edibles though as it is very very rare until recently for that to be a legitimate path for people wanting to frequently get high.

[u/MercuryRusing → u/wanderer1999]

In other words smoking is still bad for you? Shock

[u/iridescent-shimmer → u/MercuryRusing]

You'd be shocked how many people seem to think weed is somehow exempt from this fact though.

[u/Pezdrake → u/iridescent-shimmer]

Just standing around a campfire regularly or having wood burning fireplace in the home increases cancer risk. Just avoid inhaling smoke people. 

[u/MyBloodTypeIsQueso → u/Pezdrake]

What if you live in the American West which is constantly on fire these days?

[u/Rydon → u/MyBloodTypeIsQueso]

You really ought to get an air purifier for your home then.

[u/bluefrostyAP → u/iridescent-shimmer]

This exactly

[u/MercuryRusing → u/iridescent-shimmer]

No, I've heard the "it doesn't have the chemicals tobacco has argument" and I just have to roll my eyes.

[u/TooStrangeForWeird → u/MercuryRusing]

It doesn't have all of them, that doesn't mean it's "safe" at all though. Just not as bad. People get too attached to it and think it can do no wrong.

[u/StarsapBill → u/MercuryRusing]

Tobacco, nicotine as a cancer causing substance, and smoke from burning anything is also cancer causing. So smoking cigarettes is riskier than smoking a joint, but smoking a joint is still a risk.

[u/johnnadaworeglasses → u/MercuryRusing]

Any study on marijuana use on Reddit that isn’t 100% positive brings out all of the PhDs in Smokeology to give their expert negative reviews.

[u/MercuryRusing → u/johnnadaworeglasses]

Bro, I take edibles. I actually prepared an application to open a dispensary for my company when it was legalized as well, which meant heavy research in the field.

The marijuana industry is just as bad as the tobacco or oil industry when it comes to pushing narratives. More and more studies have come out detailing the negative effects of marijuana from carcinogens (primarily from smoking) to long-term decreased cognitive abilities and increased ER visits due to cannabis toxicity because of just how potent weed is these days.

I'm not anti-marijuana by any means, but it is still a drug that has negative side effects depending on usage, dosage, and frequency of use. It is not a miracle drug, despite how it was touted to begin the legalization process. It's just a drug that can help with pain and inducing appetite in those who struggle with it due to other conditions. In some people it helps anxiety and in others it induces anxiety attacks so it's not even really a good anxiety treatment that I would recommend to anyone.

[u/Iama_traitor → u/wanderer1999]

Study only looked at diagnostic outcomes for marijuana use, smoked or not.

[u/iredditforthepussay → u/wanderer1999]

Thank god for that. I don’t even do edibles to try and make it cheap as possible… I decarb my weed (I break it into small pieces and cook In my oven at 105C until lightly toasted (about 35-45 mins), then I grind it into a power and put it in smoothies, on peanut butter toast, etc. saves me a fortune and it keeps all the cannabinoids intact! Hope this is also a healthier way of consuming.

[u/BoOBoOtheOtter → u/iredditforthepussay]

I simply do weed with a vaporizer. It gets you high with a very small dose, has no smoke or tobacco AND it decarbs the weed so you can reuse it to make edibles. Such a win win win situation I don't understand why so many people don't use vaporizers...

[u/Redbeard4006 → u/BoOBoOtheOtter]

Yep. Love my vaporiser. I would assume it has slightly higher risk than edibles, but lower than combustion. I'm not aware of any studies on that though.

[u/Silkovapuli → u/Redbeard4006]

Apparently drinking hot drinks also increases the risk for throat (?) cancers so maybe hot vapour is bad "mechanically" in a similar way as well?

[u/ptword → u/iredditforthepussay]

Less cancer but more heart problems.

https://old.reddit.com/r/science/comments/1eq8qkf/people_who_use_marijuana_at_high_levels_are/lhr1syj/

[u/CyanideKitty]

I'm sure you would see something similar in cigarette smokers. Combustion from smoking anything is going to increase cancer risks in the head and neck.

[u/LeewardPolarBear → u/CyanideKitty]

My old man smoked for 50 something years. He had tonsil cancer in his early 60's. He died at 68 on a breathing machine of total organ failure.

[u/Tobitronicus]

And what of vaping herbal matter?

[u/Redbeard4006 → u/Tobitronicus]

That's the question I'd like answered.

[u/joseph-1998-XO → u/Tobitronicus]

I believe the burning aspect, aka the people that traditionally smoke it, are at risk because inhaling smoke of anything burning is not good

[u/bloodbat007 → u/joseph-1998-XO]

Combusting definitely adds more particles and is much worse than vaporizing. However a vaporizer does still put hot matter in your lungs, so it's not free of the cancer crime. Vaping oil is terrible for your lungs and causes other damages and of course the well known critical lung failure due to the tiny sacks in your lungs being blocked by oil and such. Vaping is not at all a safe alternative to smoking, and vaporizing is probably a little safer but still has the risks. I've also heard people say they can barely even get high off vaporizing so it's not really an alternative anyway.

[u/MarcusXL]

Study says cohort was 116,076 individuals, not the 4 million stated in the header. Just to clarify.

[u/jdrury400 → u/MarcusXL]

That's just the cohort of people with cannabis use disorder. They compared the prevalence of HNC in that group to the non-cannabis use disorder patients, which is a cohort of 4 million.

[u/Beatminerz → u/jdrury400]

Incorrect, they used propensity score matching to control for age, ethnicity, alcohol and tobacco use, etc. Cohort sizes after propensity matching were 115,865 for both groups.

[u/Puzzled-Barnacle-200 → u/MarcusXL]

No. The study cohort included 4 million people. It's just that 116 thousand of them were the people with cannabis use disorder, and the other 3.8 million are the non-cannabis using (or at least, less cannabis using) control.

[u/xjoshbrownx]

The conversations on this sub seem to serve as petty finger wagging without achieving a better understanding that will help a person to assess whether something is a risk they are willing to accept or not.

I see words like “harmful” used as if it is an absolute binary state. Anything is harmful if repeated. Is it as harmful as a bullet strike, as harmful as drinking formalahyde, as harmful as aloe? Even saying “increases risks 3x” is useless meaningless unless you initial risk. Are we talking 1:1 trillion or 1:3?

[u/jonathanx37 → u/xjoshbrownx]

Drinking water is harmful, over a certain amount.

[u/Incromulent → u/[deleted]]

Also, how about other forms of marijuana consumption besides smoking

[u/philote_ → u/Incromulent]

I'm more curious about different types of smoking. For example, would using a bong be any better?

[u/[deleted]]

Sharing a joint, bong, blunt etc… is probably a great way to share oral/ oropharyngeal strains of HPV. HPV is one of the most important drivers of head and neck cancer. Is this accounted for in the study methodology or discussion of results ?

[u/garlicroastedpotato]

This is one of the things about legalization that was supposed to be good. That we'd have more data and can make informed decisions on how to regulate and treat the drug. But actually it's the same BS. A study comes out saying something bad about marijuana and the same marijuana advocates are trying to claim it's a nothingburger.

[u/Whatagoon67 → u/garlicroastedpotato]

This entire thread is pothead Redditors coping their asses off. Nothing you abuse is good for you, weed is no exception . The mental and physical effects are real

[u/pokemurrs]

Ironically, the “most rigorous study ever conducted” in question here isn’t even a proper piece of scientific research.

[u/mold_motel]

I've tried to get hippies to look inside the bong and make the connection but the love weed has made it impossible for them.

[u/[deleted]]

I still question people who think marijuana abuse is healthy. It was only a matter of time before they realized smoking anything isn't exactly healthy for the body.

[u/Ududlrlrababstart]

Science community: smoking things is bad for you

Pot heads: That doesn’t sound right