Asthma is more common among U.S. individuals who reported cannabis use in the past 30-days, with the odds of asthma being significantly even greater among individuals who reported cannabis use 20 to 30 days per month, according to a new study by researchers at Columbia University Mailman School of Public Health, City University of New York and Children’s National Hospital at George Washington University. Until now little was known about the use of cannabis among youth and its relationship with asthma. The findings are published in the journal, Preventive Medicine(link is external and opens in a new window).
 
The study results show that the more frequent the use, the higher the likelihood of asthma and there is little change after adjusting for cigarette use.
 
“With the growing use of cannabis across the U.S., understanding potential links between cannabis use and asthma is increasingly relevant to population health. This relationship is an emerging area and requires thorough collaborative investigation by experts in these fields,” said corresponding author Renee Goodwin, PhD, in the Department of Epidemiology at Columbia Mailman School of Public Health and Epidemiology at the City University of New York.
 
Data were drawn from the 2020 National Survey on Drug Use and Health a representative, annual survey of 32,893 individuals aged 12 and older in the United States. The researchers used regression modeling to examine the relationship between frequency of any cannabis and/or blunt (i.e., cannabis smoked in a hollowed-out cigar) use in the past 30 days among individuals with current asthma, and adjusting further for demographics and current cigarette smoking.
 
Current asthma was more common among individuals who reported cannabis use in the past 30-days, relative to those who did not (10 percent vs. 7.4 percent.) The odds of asthma was significantly greater among individuals reporting cannabis use 20-30 days/month and blunt use, 6-15 and 20-30 days/month respectively, than in individuals without asthma. Overall, the prevalence of asthma was 7.4 percent in the sample.
 
“Our findings add a significant layer to the nascent body of research on potential harms associated with cannabis use by being the first to show a link between cannabis use in the community and respiratory health risks; specifically increased asthma prevalence. Examining asthma prevalence in both adolescents and adults helps to inform public health initiatives and policies geared towards mitigating its risks, and underscores the importance of understanding the interplay between cannabis use and respiratory health.”
 
Co-authors are Chaoqun Zhou, Columbia University; Kevin D. Silverman, City University of New York; Deepa Rastogi, Albert Einstein College of Medicine; and Luisa N. Borrell, City College of New York.
 
The study was supported by the National Institutes of Health/National Heart, Lung and Blood Institute, grant 1R21HL149773-01.

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A study by researchers at Columbia University Mailman School of Public Health and Oregon State University based on national data found that in states where recreational marijuana has been legalized, young adults who were not in college more often became frequent users of the drug than those in other states. The findings are published in the American Journal of Preventive Medicine(link is external and opens in a new window).

After state legalization, young adults also were more likely to meet the criteria for cannabis use disorder, meaning that they continued to use the drug despite problems it caused in their lives. These patterns were not found in young adults who were in college.

The study used data from the National Survey on Drug Use and Health from 2008-2019, which surveyed college-eligible young adults ages 18-23 about their drug and alcohol use. The dataset is representative of the demographics of young adults nationally and at the state level, and the study covers a longer stretch of time post-legalization than previous research, according to the researchers.

“It might surprise people that research has been mixed on whether young adults’ cannabis use has increased since legalization,” said David Kerr, PhD, professor in OSU’s School of Psychological Science and first author. “Our results show that prior to legalization 23 percent of non-college young adults used cannabis in the past month, compared to 28 percent after legalization.” 

While the percentage of non-college young adults who reported past-month cannabis use increased by 5 percentage points, it only increased by 1 percentage point among college students in the same age bracket, from 20 percent to 21 percent.

Frequent cannabis use—using the drug at least 20 times in the past month—also increased more among non-college young adults, from 12 percent to 14 percent. The prevalence for college students was 7 percent and did not change after legalization. Kerr noted that the research did not account for the fact that the potency of cannabis is higher in legal states and has increased dramatically over time.

Cannabis use disorder among non-college participants also grew from 12 percent to 15 percent while staying the same, at 10 percent among college students. 

“Our research doesn’t address why these changes are occurring, but if you’ve been to a state that has legalized recreational cannabis use you’ll notice the drug is widely available and prominently advertised. Americans’ beliefs about the benefits and harms of cannabis use are also changing rapidly,” Kerr said, citing a report from the Monitoring the Future study showing that  in 2020 only 21 percent  of young adults believed regular cannabis use puts people at risk of harm, compared to 58 percent  of young adults 20 years ago. 

Increased acceptance of cannabis use at the societal level could affect the rate at which users experience cannabis use disorder, the authors note, because many of the negative consequences associated with the disorder are social in nature. 

“Cannabis use disorder involves inability to fulfill major obligations at work, school or home, and then continued use,” Kerr said. “It is possible that there may be fewer social consequences now that the environment is more accommodating,” he said. “If so, then our findings may actually have underestimated these increases,” he added.

The study also found that in states where legalization occurred, recent cannabis use increased more among young adults ages 21-23 (from 21 percent to 26 percent) than among 18-20-year-olds (from 22 percent to 23 percent).

“That’s consistent with our prior work, that it increased more among the people who could legally buy it and use it,” Kerr said. “It suggests the law provisions requiring people to be at least 21 are at least somewhat effective.” 

“Researchers should continue to monitor changes in prevalence of cannabis use, frequent cannabis use and cannabis use disorder among young adults while the cannabis landscape in the U.S. continues to evolve,” said senior author Silvia Martins, MD, PhD, professor of Epidemiology at Columbia Mailman School of Public Health. “It is also important to better understand why increases to date were more pronounced in young adults not in college.”  

Co-authors are Natalie Levy, Columbia University Mailman School of Public Health; Harold Bae, Oregon State University; and Anne Boustead, Arizona State University.

The research was funded by a grant from the National Institute on Drug Abuse.

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The research also finds that casual cannabis use puts teens at risk for problem behaviors, including poor grades, truancy, and trouble with the law, which can have long-term negative consequences that may keep youth from developing their full potential in adulthood.

Co-author Mark Olfson, MD, MPH, professor of epidemiology at Columbia Mailman School of Public Health, and Elizabeth K. Dollard Professor of Psychiatry, Medicine and Law at Columbia University Irving Medical Center, said, “The new findings suggest that the roughly 2.5 million young people in the United States who casually use cannabis are at increased risk for a range of adverse events from depression to poor school performance.  This group is almost four times larger than those who meet formal criteria for cannabis use disorder. Contrary to the growing public acceptance of moderate cannabis use, these new results suggest that clinicians should screen, evaluate, and, when appropriate, treat adolescents who casually use cannabis.”  

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