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Is secondhand cannabis smoke harmful?

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In 1998, Ross Rebagliati took the gold medal for the men’s giant slalom snowboarding event at the Winter Olympics in Nagano, Japan. The day after his victory, he was stripped of his medal following a positive test for marijuana. Rebagliati’s urine test showed 17.8 nanograms in his system, while the limit at the time was 15 nanograms. 

Rebagliati maintained that the positive test was caused by secondhand smoke he inhaled at a party the night before he left for the Olympics, and a contentious appeal saw Rebagliati reinstated with his gold. Still, the event left many wondering—just how potent is secondhand cannabis smoke?

Beyond the issue of accidentally getting high, there are respiratory risks associated with secondhand weed smoke. Let’s look at the effects of secondhand cannabis smoke, how it compares with secondhand tobacco smoke, and also whether secondhand cannabis vapor poses any health problems.

Risks associated with secondhand cannabis smoke

Research tells us that secondhand cannabis smoke presents two significant risks for non-smokers. For starters, individuals who are not actively smoking but inhale secondhand weed smoke may become mildly intoxicated from THC. The other issue is that cannabis smoke contains hundreds of different types of chemicals and particulates (tiny particles of matter) that can be toxic to those who inhale it—secondhand or not.

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Does secondhand smoke lead to a contact high?

Back in 2014, a group of Johns Hopkins researchers carried out a study to learn more about the effects of secondhand weed smoke on non-smokers. 

The researchers placed six cannabis smokers and six non-smokers in a small sealed chamber for three one-hour sessions.

  • In the first session, the chamber was unventilated, and the smokers were given joints containing 5.3% THC to smoke. 
  • In the second session, the chamber remained unventilated, and the smokers consumed 11.3% THC joints. 
  • The final session allowed ventilation fans to run in the chamber while the smokers again consumed 11.3% THC joints. The ventilation system was designed to emulate typical home air-conditioning conditions based on HVAC-building standards. 

The findings revealed two critical factors: Ventilation and THC potency both play a part in determining whether non-smokers returned positive marijuana drug tests. 

In the first session, one non-smoker produced a positive drug test with THC levels around the 20 nanograms/mL cutoff (although, this is significantly lower than the federal cutoff for a positive screen, which is 50 nanograms/mL). In the second session, four non-smokers produced positive tests up to 22 hours after exposure. 

No participants in session three (the ventilated session) had any positive tests, showing that room ventilation played a role in lowering secondhand smoke exposure. Further analysis showed that the individuals breathing secondhand smoke during the first two sessions experienced some mild cognitive impairment.

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However, even the study’s authors acknowledge that the first two sessions of the study were somewhat unrealistic. One researcher described those test conditions as a “worst-case scenario” because those conditions could not “happen to someone without him or her being aware of it.” In other words, the study tested for the likelihood of secondhand smoke intoxication by creating an extreme situation that was unlikely to happen in reality.

The study’s conclusion also conceded that in more normal circumstances, positive drug tests among non-smokers would be unlikely, limited to the day after immediate exposure, and would only occur when exposure to secondhand smoke was extreme (i.e. in a closed room with no ventilation). The findings of the third testing session are perhaps therefore the most applicable to real-life: In a ventilated, air-conditioned room, those exposed to secondhand weed smoke wouldn’t test positive for THC.

Increases in particulate matter

A more recent study in 2022 explored the effects of bong smoking and found that bong smoke significantly increased the quantity of particulate matter—microscopic solids or liquid droplets— in the air of a space up to 1,000 times. 

In one session monitored 12 hours after smoking stopped, particulate matter in the air remained more than ten times the concentration in the room before smoking. The researchers emphasized that even 15 minutes of bong smoke produced a particulate concentration more than twice the Environmental Protection Agency’s hazardous air quality threshold. Exposure to particulate matter above the suggested guidelines has been linked to reduced lung function and increased mortality from lung cancer and heart disease.

However, while there’s conjecture about the effects of secondhand weed smoke on health, no research has yet established a direct causal link between secondhand smoke and any illness or disorder. 

Cannabis clinician Dr. Benjamin Caplan, MD, Founder and the Chief Medical Officer of CED Clinic and CED Foundation emphasizes that available research needs to be contextualized, and that assumptions and biases can lead people down the wrong path. 

He points out that public health science has repeatedly demonstrated that near-constant exposure to air pollution in urban settings is linked to a higher risk of morbidity and mortality.

 “It is hard for anyone to convincingly argue that the dangers of cannabis smoke, consumed secondhand, poses greater harm than the ever-present smoke and smog of modern city life,” he reflected. “Whether or not secondhand cannabis smoke represents a meaningful drop of toxicity or not—and the debate is justified and ongoing—it is likely, literally, a small drop in a large bucket.”

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Secondhand cannabis smoke vs. secondhand tobacco smoke

There’s a widespread conception that weed smoke isn’t as harmful as tobacco smoke. As many as 27% of young adults believe secondhand cannabis smoke exposure is safe. However, evidence suggests that both secondhand cannabis and tobacco smoke exposure can trigger asthma attacks, lung irritation, and respiratory infections.

Cannabis smoke may also produce more particulate matter than tobacco. In the 2022 bong-smoking study mentioned above, the researchers discovered that bong smoke created four times as much particulate matter as cigarettes. They pointed out that this level of air pollution could potentially contribute to many health problems for those exposed to secondhand smoke, not to mention the smokers themselves.

However, research also suggests that tobacco smoke, secondhand or otherwise, is significantly more carcinogenic than cannabis smoke. Cannabis smoke hasn’t been causally linked with tobacco-related cancers such as lung, colon, or rectal cancer. 

One study speculates that tobacco smoke is more likely to cause lung cancer than weed smoke due to the beneficial activity of compounds present in the cannabis plant. The pharmacological properties of cannabinoids in weed may minimize carcinogenic (cancer-causing) activity in several ways: THC, for example, can inhibit the activity of certain enzymes that are needed to activate the cancer-causing components of smoke. Large-scale clinical studies comparing cannabis and tobacco smokers are needed, however, to learn more and confirm this theory.

Overall, Dr. Caplan emphasizes that much of the research on secondhand tobacco smoke risks has been loosely applied to secondhand cannabis smoke, without adequate evidence.

“In terms of chemical constituents, nicotine is a poisonous toxin, with a plethora of ill effects ranging from promoting cancer and respiratory disease to wreaking cardiovascular damage and mental, oral, reproductive, and addictive consequences,” he said. “These effects are rumored to be relevant to cannabis, though the evidence is far less clear.”

Is secondhand weed vapor harmful?

With the popularity of vaping, it’s worth diving into the data on the effects of secondhand weed vapor. Of the evidence available, it appears that secondhand vapor may also pose some risks.

In a recent study carried out in a well-ventilated cannabis dispensary and consumption space where vaporizing and dabbing were permitted (but smoking was banned), researchers found that vaping produced particulate concentrations high enough to impact cardiovascular health. The concentration of particulates in the air was roughly 28 times higher when the lounge was open and people were actively smoking than when the business was closed. Peak daily particle concentrations corresponded with the busiest hours.

“While vapor has fewer potential irritants than smoke, it may represent a far more dense cloud of material,” said Caplan. However, Caplan also points out that cannabis vapor is thought to produce fewer toxic compounds than cannabis smoke. 

“Both smoke and vapor contain tar, but they have different compositions,” explained Caplan. “Vapor is produced at lower temperatures than smoke, thus has fewer chemical reactions, and often fewer harmful compounds are produced.”



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Can lemon-smelling weed cause less anxiety than others?

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Top study takeaways:

  • Ever eat mangos to help you get higher? Maybe pound some lemonade to prevent anxiety
  • Test subjects who vaped lots of the terpene limonene with their weed reported lower anxiety in a small study

Leafly Ph.D Nick Jikomes dissects the hype new study on the smell molecule limonene below. Report your findings in the comments section.

The “entourage effect” is the idea that the psychoactive effects of cannabis result from a combination of different plant molecules. The idea is widely used in the cannabis industry to help explain the distinct effects that cannabis strains are reported to have–each one contains a different combination of THC, terpenes, and other compounds. These claims have been largely theoretical, with limited empirical evidence to show that specific combinations of cannabinoids and terpenes reliably induce measurably different effects in humans.

A new study, however, investigates whether the common cannabis terpene limonene, when consumed together with THC, results in different effects compared to THC on its own.

A bit of limonene is in many weed varieties

Limonene is one of the most abundant terpenes found in commercial cannabis. Cannabis strains with the highest limonene levels typically contain between 1 to 3% limonene by weight. Commercial THC-dominant cannabis flower today often has THC content in the 20-25% range, meaning that the most limonene-rich strains will have a roughly 20:1 ratio of THC to limonene. 

Limonene is found naturally in many citrus fruits. On its own, it has a pleasant, citrus aroma. A limited number of animal studies have observed anti-anxiety effects in rodents given limonene. Similar observations have been made in human studies, although they had small sample sizes or lacked important controls. Given that anxiety is a common side effect of THC—especially when relatively large doses are consumed—it has been hypothesized that limonene may be able to mitigate these effects. If true, this would suggest the possibility that THC-dominant strains high in limonene might be less likely to elicit anxiety than those with lower limonene content. 

Vaping limonene and THC—for science!

A robust terpene profile in weed adds to the flavour and overall experience. (MysteryShot/Adobe Stock)
(MysteryShot/Adobe Stock)

In this new study, researchers at Johns Hopkins administered different combinations of THC, limonene, and a placebo of distilled water to twenty human subjects in a double-blind trial. Each person participated in several separate vape sessions where they received one of the following:

  • Limonene alone (1mg or 5mg)
  • THC alone (15 mg or 30 mg)
  • THC + limonene together (15 or 30 mg THC + 1 mg limonene)
  • THC + limonene together (15 or 30 mg THC + 5 mg limonene)
  • THC + limonene together (30 mg THC + 15 mg limonene)
  • Placebo (distilled water)

The subjects were healthy adults who used cannabis intermittently. A hand-held Might Medic vaporizer (made by Storz and Bickel) was used for administration. Subjects consumed 15 and 30 mg doses of THC because, based on previous research, those doses often trigger small (15 mg THC) to moderate/large (30 mg THC) psychoactive effects, with the larger dose expected to trigger more side effects like anxiety. Researchers assessed participants using standardized questionnaires. One of these, the “Drug Effect Questionnaire,” asks subjects to rate various subjective drug effects on a 0-100 scale. Another, the “State-Trait Anxiety Inventory (STAI-S),” assessed their anxiety/distress levels before and after drug administration. Researchers also tracked heart rate, blood pressure, and plasma levels of THC and limonene. (For more details on the study methods, including the standardized procedures, check out the paper itself.)

What did they find? Did the presence of limonene affect the subjective effects of THC, or reduce side effects like anxiety and paranoia?

Three limonene-dominant hype strains

A photo of Connected Gelonade — Lemon Tree and Gelato. (David Downs/Leafly)
Gelonade. (David Downs/Leafly)

And the results come in

I recently spoke with the lead author of the study, Dr. Ryan Vandrey of Johns Hopkins University, about how his team designed the study and built in important controls. For one: test subjects received the real deal molecules, not some burned-up version.

“We made sure that when we heated it at this temperature, this device, we didn’t convert these things into something else,” Dr. Vandrey explained. “So we were very careful to get our dosing methods secure, and to work with this. We opted for inhalation and vaporization in particular, so we know that our doses are being delivered fully and completely.”

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Consumption of THC went as planned. The control placebo containing 0 mg THC did not cause substantial subjective effects, anxiety or paranoia, or changes in heart rate. Consumption of 15 or 30 mg of THC did trigger these changes, with the higher dose producing larger effects on average.

“We picked two doses of THC, 15 milligrams and 30 milligrams, which to the occasional cannabis user will get people moderately high at pretty dang high,”

Dr. Ryan Vandrey, Johns Hopkins University

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But did consumption of limonene together with THC lead to different effects compared to the same dose of THC alone? Yes—if you’re limonene-maxing.

When limonene was administered alone, without THC, its effects did not differ compared to the placebo.

But with co-administration of THC and limonene, however, the team saw differences compared to THC alone, but only at the highest dose of limonene (15 mg).

Compared to 30 mg of THC alone, consumption of 30 mg THC + 15 mg limonene resulted in lower subjective ratings for “anxious,” “paranoid,” and “unpleasant drug effect.”

Subjective ratings of “anxious” and “paranoid” were less than half of those seen with 0 mg limonene.

Subjective ratings of “anxious” and “paranoid” were less than half of those seen with 0 mg limonene.

Although the result was statistically significant at the highest limonene dose (20 mg), the sample size (n=20) was small and it’s not clear if most subjects saw this effect, or a small minority experienced large differences.

The presence of limonene did not influence physiological measures like heart rate, nor did it lead to differences in the intensity of THC’s subjective effects or blood levels of THC.

“That’s important… because it suggests that limonene isn’t somehow interfering with THC absorption. It’s not somehow changing the pharmacology. It’s not blocking THC’s ability to bind to the cannabinoid receptor,” Dr. Vandrey told me.

Did test subjects detect any lemon?

image-of-cannabis-judge-smelling-weed
(AdobeStock)

Because limonene has a taste, smell, and influences vapor quality, blinding may have been an issue, especially at higher doses of limonene.

Put another way, if subjects could taste or smell this terpene, or noticed that the vapor felt different, it could have colored their experience.

According to Dr. Vandrey, however, the team’s drug delivery design minimized the subjects’ ability to discern what they were consuming via taste or sight.

“We did everything to maintain the blind in this study,” he said. “The drugs were sealed inside of the vaporizer, but they couldn’t see it, they couldn’t smell it or anything like that.”

Weed’s entourage effects remain hard to pin down

While the results of Vandrey’s study proved statistically significant, the size of the effect was quite modest. Co-administering THC with 15 mg of limonene resulted in decreases of anxiety, but not 1 mg or 5 mg of limonene.

It’s important to note a key caveat: Subjects were not consuming whole-plant cannabis products like those we can buy in dispensaries. They were only consuming specific combinations of THC and/or limonene.

The modest effects they saw were only seen with 30 mg of THC with 15 mg limonene, which is a 2:1 THC:limonene ratio. This is not a combination found in commercial cannabis flower. Expect a roughly 20:1 THC:limonene ratio for even the most limonene-rich strains.

Taken at face value, the results of the Johns Hopkins study indicates maxing out on limonene may reduce The Fear.

However, they do not demonstrate that limonene-rich, THC-dominant cannabis purchased from a dispensary contains enough limonene to accomplish the same goal.

If limonene or other cannabis terpenes can indeed reliably modulate the effects of THC in commercially-available cannabis products, future research will have to focus on them. Such products contain more complex mixtures of THC and a variety of terpenes and other molecules, many of which are present at low levels. Does the “entourage effect” really explain all the effects of weed? Researchers will need to carefully measure the effects of real-world stuff to know for sure.

For more detail on this study, listen to my full conversation with Dr. Ryan Vandrey. Mind & Matter is a science column by Nick Jikomes, PhD focuses on how psychoactive drugs influence the mind & body. It is inspired by the long-form science podcast, Mind & Matter.

What do limonene strains do to you? Sound off in the comments below.



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“A big deal”: What the feds’ move to reclassify marijuana means for Colorado cannabis

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Cannabis advocates in Colorado cheered the Biden Administration’s reported move to reclassify marijuana and said the decision likely would reduce businesses’ tax burden significantly.

Industry leaders cautioned that such a move — if finalized — would not resolve some major challenges facing the industry, such as limited access to banking. But they pointed to the symbolic importance of preparations by the U.S. Drug Enforcement Administration to downgrade the substance’s drug classification.

A man pours cannabis into rolling papers as he prepares to roll a joint the Mile High 420 Festival in Civic Center Park in Denver, April 20, 2024. (Photo by Kevin Mohatt/Special to The Denver Post)

Read the rest of this story on DenverPost.com.



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Study: Cannabis can make workouts more fun, but it’s no performance-enhancer

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The study of 42 runners, published Dec. 26 in the journal Sports Medicine, comes almost exactly 10 years after Colorado became the first state to commence legal sales of recreational marijuana, at a time when cannabis-users increasingly report mixing it with workouts. “The bottom-line finding is that cannabis before exercise seems to increase positive mood and enjoyment during exercise, whether you use THC or CBD. But THC products specifically may make exercise feel more effortful,” said first author Laurel Gibson, a research fellow with CU’s Center for Health and Addiction: Neuroscience, Genes and Environment (CU Change).

https://www.colorado.edu/today/2024/01/03/study-cannabis-can-make-workouts-more-fun-its-no-performance-enhancer



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