Barbers RG et al. Journal of Psychoactive Drugs. 1988;20:15-20. (Chemotaxis of peripheral blood and lung leukocytes obtained from tobacco and marijuana smokers.

Barsky SH, Roth MD, Kleerup EC, Simmons M, Tashkin DP. Histopathologic and Molecular Alterations in Bronchial Epithelium in Habitual Smokers of Marijuana, Cocaine, and / or Tobacco. Journal of the National Cancer Institute, 1998;90:1198-1204. (Bronchial mucosa biopsy specimens and brushings demonstrated statistically significant molecular abnormalities in marijuana and / or cocaine smokers that have been associated with an increased risk of development of lung cancer.)

Benowitz NL, Jones RT. J Clin Pharmacol 1981;21 (suppl 8-9):214-235. (Cardiovascular and metabolic considerations in prolonged cannabinoid administration in man.)

British Medical Association, Therapeutic Uses of Cannabis. 1997. P.73..... "The health risks associated with smoking tobacco have been well documented and many of the same constituents are present in cannabis smoke, including most of the known carcinogens."

Buckley J, Cannabis: Physiopathology, Epidemiology, Detection. CRC Press 1993;155-162. (A case-control study of acute non-lymphoblastic leukemia: evidence for an association with marijuana exposure.)

Cocita-Baldwin G, Tashkin DP, Buckley DM, Park AN, Dubinett SM, Roth MD. Marijuana and cocaine impair alveolar macrophage function and cytokine production. Am J Respir Crit Care Med 1997;156:1606-1613. (Marijuana and cocaine severely limit the ability of alveolar macrophages to kill bacteria and tumor cells. Marijuana smokers smoked at least 5 per day for 5 yrs. Ave 17.9 joints per week and 54 joints per year.)

Denissenko M, Pao A, Tang M, Pfeifer GP. Preferential Formation of Benzo (a)pyrene Adducts at Lung Cancer Mutational Hotspots in P53. Science Vol. 274, 18 October 1996. (These results provide a direct etiological link between a defined chemical carcinogen and human cancer.) An average marijuana cigarette contains 30 nanograms of this carcinogen, compared to 21 nanograms in an average tobacco cigarette (Marijuana and Health, National Academy of Sciences, Institute of Medicine report, 1982). This potent carcinogen suppresses a gene that controls growth of cells. When this gene is damaged, the body becomes more susceptible to cancer. This gene, P53, is related to half of all human cancers and as many as 70% of lung cancers.

Diaz and colleagues. Journal of Pharmacology and Experimental Therapeutics, 268:1289-1296, 1994. (Normal human cells, when incubated with concentrations of THC equivalent to that found in the blood of regular smokers of marijuana, cause immune cells to release compounds which promote inflammation within the lungs, and at the same time, suppress the natural defences against external bacterial and viral agents that cause disease.)

Donald PJ, Otolaryn Head & Neck Surg 94:517-521, 1986. (Cases of cancer, including cancer of the mouth, tongue, larynx, jaw, head, neck, and lungs have been reported in marijuana smokers.)

Donald PJ. Adv Exp Med Bio 288:33-46, 1991. (Cases of cancer, including cancer of the mouth, tongue, larynx, jaw, head, neck, and lungs have been reported in marijuana smokers.)

Ferguson RP et al. JAMA 261:41-42, 1989. (Cases of cancer, including cancer of the mouth, tongue, larynx, jaw, head, neck, and lungs have been reported in marijuana smokers.)

Fligiel SE, Venkat H, Gong H, Tashkin DP. Journal of Psychoactive Drugs. 1988; 20:33-42. (Bronchial pathology in chronic marijuana smokers: a light and electron microscopic study.)

Fligiel SEG, Roth MD, Kleerup EC, Barsky SH, Simmons MS, Tashkin DP. Tracheobronchial histopathology in habitual smokers of cocaine, marijuana, and/or tobacco. Chest 1997;112:319-326 (Smokers of cocaine, marijuana, or tobacco had greater histopathologic abnormalities than controls and the effects were additive. The effects of marijuana were greater than tobacco or cocaine)

Gong H, et al. Clin Pharmacol Ther. 1984;35:26-32. (Acute and subacute bronchial effects of oral cannabinoids.)

Huber GL. Griffith DE, and Langsjoen PM. 1988 pgs 3-18 in Marijuana: An International Research Report, Monograph Series No.7, edited by G. Chesher, P. Consroe, and R. Musty. Australian Gov. Publ. Service, Canberra, Australia. The Effects of Marijuana on the Respiratory and Cardiovascular Systems. (Respiratory and cardiovascular effects of marijuana are reviewed. Topics include difficulties in studying this population, effects on the lung, lung cancer, paraquat, passive inhalation, experimental lung disease, and cardiovascular effects. In general, effects on the cardiovascular system appear to be primarily beta-agonist in nature with a secondary vagal-mediated CNS effect resulting in an increase in heart rate.)

Huber, Gary: Pharm. Biochem. Behavior Vol.40. P630, 1991. National Academy of Sciences, Institute of Medicine Report, Washington DC 1982. (Known carcinogens in marijuana, vinyl chloride, dimethylnitrosamine, methylethylnitrosamine, benz(a)anthracene, benz(a)pyrene.)

Klein TW, Newton C, Widen R, Friedman H. Delta-9-THC injection induces cytokine mediated mortality of mice infected with legionally pneumophila. Journal of Pharmacology and Experimental Therapeutics 1993;267:635-640. (THC injection increases blood levels of acute phase cytokines in infected animal were at least in part responsible for increased mortality.)

Macinnis DC, Miller KM. J R Coll Gen Pract 1984;34:575-6. (Fatal coronary artery thrombosis associated with cannabis smoking.)

Polen et al. Western Journal of Medicine, Vol. 158, pp 596-601, 1993. (Daily marijuana smokers had a 19% increased risk of out patient visits for respiratory illnesses, a 32% increased risk of injury, and a 9% increased risk of other illnesses compared to non-smokers. They also had a 50% increased risk of being admitted to hospital.)

Ramirez RJ. American Journal of Medicine. 1990; 88: 5-60N-5-62N. (Acute pulmonary histoplasmosis: newly recognized hazard of marijuana plant hunters.)

Robison LL. et. al. Cancer. 1989; 63:1904-1911. (Maternal drug use and risk of childhood non-lymphoblastic leukemia among offspring.)

Roth MD, Arora A, Barsky SH, Kleerup EC, Simmons M, Tashkin DP. Airway inflammation in young marijuana and tobacco smokers. Am J. Respir Crit Care Med 1998;157:928-937. (Conclusion that smoking marijuana by young adults is associated with significant airway inflammation similar to tobacco smoking.)

Rubenstein KE. Marihuana: Biological effects. Oxford: Pergamon Press (1979), pp. 89-99. (Determination of cannabinoids in urine by EMIT homogeneous enzyme immunoassay.)

Sarafian TA, Marques JA, Shau H, Tashkin DP, Roth MD. Am J Respiratory Molecular and Cell Biology 1999. (In press) (Oxidative stress produced by cannabinoids in marijuana smoke.)

Schwartz RH, Voth EA, Sheridan MJ. Southern Medical Journal 1997: 90;167-172. (Marijuana to Prevent Nausea and Vomiting in Cancer Patients: A Survey of Clinical Oncologists.)

Sridhar K, Inciardi J, eta al. Journal of Psychoactive Drugs October 1994. Possible Role of Marijuana Smoking as a Carcinogen in the Development of Lung Cancer at a Young Age. (Reports high incidence of early onset lung cancers having history of marijuana or combined with cigarette smoking.)

Starr et al. Medical Tribune, page 17, 1994. (The study followed 25 non-tobacco smoking surfers, in excellent physical condition, who smoked an average of 2 marijuana joints per day. Damage and irritation to the lung cells of marijuana smokers was comparable to those who smoked a mean of 28 tobacco cigarettes per day.)

Tashkin DP, Shapiro BJ, Lee YE, Harper CE. New England Journal of Medicine 1976;294:125-129. (Subacute effects of heavy marijuana smoking on pulmonary function in healthy men.)

Tashkin DP, et. al. Chest. 1980; 78:699-706. (Respiratory status of 74 habitual marijuana smokers.)

Tashkin DP, Simmons M, Clark V. Journal of Psychoactive Drugs. 1988; 20:21-25. (Effect of habitual smoking of marijuana alone and with tobacco on nonspecific airways hyperactivity.)
 
 

Tashkin DP. West J Med 158:635-637, 1993. Is frequent marijuana smoking harmful to health? (Marijuana smoke produces airway injury, acute and chronic bronchitis, lung inflammation, and decreased pulmonary defences against infection. Smoking one marijuana cigarette leads to airway deposition of four times as much cancer-causing tar as does tobacco smoke.)

Tashkin DJ, Am J Respir Crit Care Med 1997 156:1606-1613. (Marijuana and cocaine impairment of alveolar macrophages and cytokine production.)

Tashkin DP, Simmons MS, Sherrill DL, Coulson AH. Heavy habitual marijuana smoking does not cause an accelerated decline in FEV1 with age. Am Respir Crit Care Med 1997; 155:141-148. (Consistent with prior findings and does not negate the previously determined effects.)

Tashkin DP. School Psychology International 1999; 20:23-37. (Effects of marijuana on the lung and its defenses against infection and cancer.)

Taylor FM. South Med J 81:1213-1216, 1988. (Cases of cancer, including cancer of the mouth, tongue, larynx, jaw, head, neck, and lungs have been reported in marijuana smokers.)

Tilles DS, et al. The American Journal of Medicine. 1986;80:601-606. (Marijuana smoking as cause of reduction in single-breath carbon monoxide diffusing capacity.)

Van Hoozen BE, Cross CE. Marijuana: Respiratory tract effects. Clinical Reviews in Allergy and Immunology 1997; 15:243-269. (Good review of the literature on the respiratory effects of marijuana.)

Wu TC, et al. New England Journal of Medicine. 1988;318:347-351. (Pulmonary hazards of smoking marijuana as compared with tobacco.)

Zhang Z-F, Morgenstern H, Spitz MR, Tashkin DP, Marshall JR, Hsu TC, Schantz SP. Cancer Epidemiology Biomarker & Prevention 1999. (In press) Marijuana use and increased risk of squamous cell carcinoma of the head and neck.

Zuskin E, Mustajbegovic J, Schachter EN. Andrija Stampar School of Public Health, Medical Faculty University of Zagreb, Croatia. Am J Ind Med July 1994 Vol.26 pp 103-115. (Our data demonstrate that work in the hemp industry, particularly in small poorly regulated mills, continues to have deleterious effects on respiratory function.)