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Original Investigation |

Associations Between Cannabis Use and Physical Health Problems in Early Midlife A Longitudinal Comparison of Persistent Cannabis vs Tobacco Users

Madeline H. Meier, PhD1; Avshalom Caspi, PhD2,3,4; Magdalena Cerdá, DrPH5; Robert J. Hancox, MD6; HonaLee Harrington, BA2,3; Renate Houts, PhD2,3; Richie Poulton, PhD7; Sandhya Ramrakha, PhD7; W. Murray Thomson, PhD8; Terrie E. Moffitt, PhD2,3,4
[+] Author Affiliations
1Department of Psychology, Arizona State University, Tempe
2Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
3Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
4Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, England
5Department of Emergency Medicine, Violence Prevention Research Program, University of California, Davis
6Department of Prevention and Social Medicine, Dunedin School of Medicine, Dunedin, New Zealand
7Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
8Department of Oral Sciences, Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand
JAMA Psychiatry. 2016;73(7):731-740. doi:10.1001/jamapsychiatry.2016.0637.
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Importance  After major policy changes in the United States, policymakers, health care professionals, and the general public seek information about whether recreational cannabis use is associated with physical health problems later in life.

Objective  To test associations between cannabis use over 20 years and a variety of physical health indexes at early midlife.

Design, Setting, and Participants  Participants belonged to a representative birth cohort of 1037 individuals born in Dunedin, New Zealand, in 1972 and 1973 and followed to age 38 years, with 95% retention (the Dunedin Multidisciplinary Health and Development Study). We tested whether cannabis use from ages 18 to 38 years was associated with physical health at age 38, even after controlling for tobacco use, childhood health, and childhood socioeconomic status. We also tested whether cannabis use from ages 26 to 38 years was associated with within-individual health decline using the same measures of health at both ages.

Exposures  We assessed frequency of cannabis use and cannabis dependence at ages 18, 21, 26, 32, and 38 years.

Main Outcomes and Measures  We obtained laboratory measures of physical health (periodontal health, lung function, systemic inflammation, and metabolic health), as well as self-reported physical health, at ages 26 and 38 years.

Results  The 1037 study participants were 51.6% male (n = 535). Of these, 484 had ever used tobacco daily and 675 had ever used cannabis. Cannabis use was associated with poorer periodontal health at age 38 years and within-individual decline in periodontal health from ages 26 to 38 years. For example, cannabis joint-years from ages 18 to 38 years was associated with poorer periodontal health at age 38 years, even after controlling for tobacco pack-years (β = 0.12; 95% CI, 0.05-0.18; P <.001). Additionally, cannabis joint-years from ages 26 to 38 years was associated with poorer periodontal health at age 38 years, even after accounting for periodontal health at age 26 years and tobacco pack-years (β = 0.10; 95% CI, 0.05-0.16; P <.001) However, cannabis use was unrelated to other physical health problems. Unlike cannabis use, tobacco use was associated with worse lung function, systemic inflammation, and metabolic health at age 38 years, as well as within-individual decline in health from ages 26 to 38 years.

Conclusions and Relevance  Cannabis use for up to 20 years is associated with periodontal disease but is not associated with other physical health problems in early midlife.

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On the decline in periodontal health for heavy cannabis users
Posted on June 5, 2016
Dr. Leonardo Della Pietra
Uni Heidelberg, Physikalisches Institut, Alumni
Conflict of Interest: None Declared

Do you have an explanation for the observed influence of cannabis use on periodontal health which can differentiate between the following:

-Negative effect of the cannabis use due to act of smoking itself.

-Negative effect of cannabis-specific chemicals at the "medical" level (like influence to the immune system).

-Negative effect due to a change in "mechanical" mouth parameters (like mastication rate).  I would like to point the attention to a phenomenon well know to cannabis users: cottonmouth.  Many users experience a pronounced reduction in the saliva flow.  This coupled with food craving and increased laziness (decreased probability of using the toothbrush after food assumption) may well play against gum health.

Reference:

http://www.ncbi.nlm.nih.gov/pubmed/18637392


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