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

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Secondary spontaneous pneumothorax and bullous lung disease in cannabis and tobacco smokers: A case-control study.
PLOS ONE ( IF 2.9 ) Pub Date : 2020-03-30 , DOI: 10.1371/journal.pone.0230419
Alessandro Stefani ₁ , Beatrice Aramini ₁ , Carlo Baraldi ₂ , Lanfranco Pellesi ₂ , Giovanni Della Casa ₃ , Uliano Morandi ₁ , Simona Guerzoni ₂

Affiliation

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 pneumothorax. A history of cannabis abuse should always be taken in patients with pneumothorax. There may be need for a specific treatment for pneumothorax in cannabis smokers.

中文翻译：

大麻和烟草吸烟者继发性自发性气胸和大疱性肺病：病例对照研究。

背景

近年来，人们开始提出吸食大麻可能损害呼吸道的观点，但对此主题的研究仍然很少。本研究的目的是调查手术患者群体中吸食大麻、气胸和大疱性肺病之间的关系。

方法和结果

我们对因自发性气胸而接受手术的患者进行了回顾性研究。根据吸烟习惯，患者被分为三组：大麻吸烟者、只吸烟者和不吸烟者。大麻终生接触量以剂量年表示（1d/y = 1 克大麻/周，持续一年）。收集临床、放射学和围手术期变量。对这些变量进行分析以找出与吸烟习惯的关联。还通过 ROC 曲线分析研究了大麻消费量的影响。

在 112 名患者中，39 名吸食大麻，23 名只吸烟草，50 名不吸烟。大麻消费量中位数为 28 剂/年，烟草消费量中位数为 6 包/年。与吸烟者和不吸烟者相比，大麻吸烟者表现出更严重的慢性呼吸道症状和大疱性肺病，并且张力性气胸的发生率更高。与不吸烟者相比，吸食大麻的人也出现了更大的气胸，术后住院时间延长，并且术后气胸复发率更高。大麻吸食者出现慢性呼吸道症状和大疱性肺病的风险与剂量相关。