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A Strange Blend: Why Are Europeans Mixing Cannabis and Tobacco?

This article was originally published on Leafly.

Cannabis doesn’t carry the sort of health hazards tobacco does, a majority of studies say. But that doesn’t change the European habit of mixing the two. It’s something North American cannabis consumers don’t often do: even cigarette smokers in Vancouver or L.A. tend smoke their flower pure, strictly separating nicotine and cannabinoids. So where does this difference come from?

To answer the question, let’s go back in time to the cannabis renaissance of the 1960s and ‘70s. Consumers in Europe at the time almost exclusively smoked hashish, often crumbling it into cigarettes, as hardly anyone was aware of the dangers of nicotine and smoking tobacco. The vast majority of cannabis consumers in the U.S., on the other hand, overwhelming had access only to dried flower, which could easily be used to roll pure joints.

These differences influenced the size of what was being rolled in North America and Europe. In the U.S. and Canada, pure “mini-joints” became the standard, while on the continent a king-size joint is preferred. A European-sized joint that contains only cannabis might contain 1.5 grams to 2 grams of flower — far too much for most. An American joint, on the other hand, contains about as much herb — about 0.2 grams to 0.5 grams — as a European mixed joint (often called a spliff in the U.S.), but without the nicotine. Scientists have even pinpointed the average amount of cannabis in an American joint at 0.32 grams. In Germany, the Netherlands, or Denmark, that amount of cannabis is typically mixed with another gram or so of tobacco, depending on personal preference.

Smoke Raw

Not only does consuming a cannabis–tobacco blend affect your health more than pure flower, it also complicates efforts to gauge the health effects of cannabis itself. The legalization debate often revolves around the dangers of “smoking,” because almost every European study on cannabis is not about smoking it pure but about cannabis mixed with tobacco. Even in medical programs, little attention is paid to whether patients smoke pure. That means that Europeans who use cannabis alone has to justify the consequences of a substance that has little to do with cannabis.

Even without tobacco, smoking is the unhealthiest form of any medical application. Yet other, healthier forms of consumption, such as vaporization or edibles, seem to catch on much more slowly in Europe. That’s in part because tobacco has long been engrained in European culture; as cannabis grew in popularity among Europeans, that affected how people chose to consume. In other cultures, where cannabis has been part of everyday life for millennia, people consume orally or at least smoke cannabis pure.

Mixing tobacco into a joint increases the addictive risks immensely. Many casual users have only begun to smoke cigarettes because they use tobacco for their joints. “Without cannabis I have no problems, but I then smoke more cigarettes” — you’ll never hear such a statement from a pure-cannabis consumer. Doctors in Germany or the Netherlands treating cannabis patients are often unaware of this phenomenon and fail to advise patients to quit tobacco— or at least to separate the consumption of both drugs so the positive effects of cannabis remain intact. The unfortunate reality is that in most instances in Europe, the pairing of cannabis and tobacco simply isn’t discussed.

Last but not least, pure cannabis acts quite differently than a cannabis–tobacco blend. Patients report that the combination of nicotine and cannabis can lead to pain relief and relaxation, but very often they note fatigue as a negative side effect.

Lung-Killer Nicotine

All these facts should be worrying enough for European cannabis fans to reflect on their consumption habits. To make things worse, there’s the political aspect. Prohibitionists use the dangers of the legal drug nicotine to protest against legalization of cannabis: “How can we have ever stricter laws to control tobacco and at the same time legalize cannabis?”

Professor Donald Tashkin has been a leading American pulmonologists for decades. In the past he was a vocal supporter of cannabis prohibition. Tashkin was convinced that smoking cannabis flowers created a high risk of developing lung cancer or chronic obstructive pulmonary disease (COPD). At one point, he was convinced that cannabis and lung cancer had a causal relationship worse than tobacco.

But more recent evaluations of long-term studies, however, made him change his mind in 2009: “Early on, when our research appeared as if there would be a negative impact on lung health, I was opposed to legalization because I thought it would lead to increased use, and that would lead to increased health effects,” he has said. “But at this point, I’d be in favor of legalization. I wouldn’t encourage anybody to smoke any substances, because of the potential for harm. But I don’t think it should be stigmatized as an illegal substance. Tobacco smoking causes far more harm. And in terms of an intoxicant, alcohol causes far more harm.”

If the legislators take their task to protect public health seriously, European studies that evaluate the risk potential of pure cannabis consumed in various forms (smoking, vaporizing, edibles) have to be undertaken. These studies should take the international state of research into account, focusing on safer ways of consuming.

Michael Knodt is Leafly’s Germany correspondent.

A Strange Blend: Why Are Europeans Mixing Cannabis and Tobacco? This article was originally published on Leafly. Cannabis doesn’t carry the sort of health hazards tobacco does, a majority

Smoking pot vs. tobacco: What science says about lighting up

by Jennifer Peltz

As more states make it legal to smoke marijuana, some government officials, researchers and others worry what that might mean for one of the country’s biggest public health successes : curbing cigarette smoking.

Though there are notable differences in health research findings on tobacco and marijuana, the juxtaposition strikes some as jarring after generations of Americans have gotten the message that smoking endangers their health.

“We’re trying to stop people from smoking all kinds of things. Why do you want to legalize marijuana?” a New York City councilman, Republican Peter Koo, asked at a recent city hearing about the state’s potential legalization of so-called recreational pot use.

Marijuana advocates say there’s no comparison between joints and tobacco cigarettes. A sweeping federal assessment of marijuana research found the lung-health risks of smoking weed appear “relatively small” and “far lower than those of smoking tobacco,” the top cause of preventable death in the U.S.

Unlike for cigarettes, there’s evidence of certain health benefits from marijuana, such as easing chronic pain. And marijuana can be used without smoking it. Most states now have legal medical pot programs; 10 states and the District of Columbia have approved recreational use.

“They’re different products, and they need to be treated differently,” says Mason Tvert, a spokesman for the pro-legalization Marijuana Policy Project.

At the same time, studies have shown crossover between marijuana and tobacco use. And while smoking cannabis may be less dangerous than tobacco to lung health, pot doesn’t get an entirely clean slate.

Some health officials and anti-smoking activists also worry about inserting legal marijuana into the growing world of vaping, given uncertainties about the smoking alternative’s long-term effects.

Here’s a look at the issues, science and perspectives:

SMOKING POT VS. TOBACCO

While cigarette smoking is the top risk factor for lung cancer, some of scientific evidence suggests there’s no link between marijuana smoking and lung cancer. That’s according to a 2017 federal report that rounded up nearly two decades of studies on marijuana, research that’s been limited by the federal government’s classification of marijuana as a controlled substance like heroin.

While cigarette smoking is a major cause of heart disease, the report concluded it’s unclear whether marijuana use is associated with heart attacks or strokes.

But there’s strong evidence linking long-term cannabis smoking to worse coughs and more frequent bouts of chronic bronchitis, according to the report from the National Academies of Sciences, Engineering and Medicine.

The report also looked at other effects, finding a mix of possible risks, upsides and unknowns. For example, the report said marijuana can ease chemotherapy-related nausea and adults’ chronic pain but also found evidence the drug is linked to developing schizophrenia and getting in traffic crashes.

In recent weeks, studies have echoed concerns about high-potency pot and psychosis and documented a rise in marijuana-related emergency room visits after legalization in Colorado.

Tobacco and marijuana use can also go together. Blunts—marijuana in a cigar wrapper that includes tobacco leaves—have gained popularity. And studies have found more cigarette smokers have used pot, and the other way around, compared to nonsmokers.

“One substance reinforces the use of the other, and vice versa, which can escalate a path to addiction,” says Dr. Sterling McPherson, a University of Washington medical professor studying marijuana and tobacco use among teens.

The National Academies report found pot use likely increases the risk of dependence on other substances, including tobacco.

To some public health officials, it makes sense to legalize marijuana and put some guardrails around it.

“For tobacco, we know that it’s inherently dangerous and that there is no safe amount of tobacco to use,” says New York City Health Department drug policy analyst Rebecca Giglio. Whereas with marijuana, “we see this as an opportunity to address the harms of criminalization while also regulating cannabis.”

But health department opinions vary, even within the same state: New York’s Association of County Health Officials opposes legalizing recreational weed.

SO WHAT ABOUT VAPING?

Vaping—heating a solution into a vapor and inhaling it—has been pitched as a safer alternative to smoking.

Experts have said vaping pot is probably less harmful to the lungs than smoking it, though there’s little research on the health effects over time, and they worry about its potency when vaped.

The American Lung Association is concerned that vaping will ultimately prove damaging to lung health and is alarmed about a surge in underage e-cigarette use. And adding legal marijuana to the picture “only makes it a more complicated issue,” says Erika Sward, an assistant vice president.

Others, though, think policymakers should view vaping as a relatively safe way to use pot.

“I would say the risks are going to be less with that form of consumption,” says Rebecca Haffajee, a University of Michigan health policy professor who co-wrote a 2017 piece calling for recreational marijuana programs to allow only nonsmokable forms of the drug.

Meanwhile, some local governments have adjusted public smoking bans to cover both vaping and pot. The Los Angeles County Board of Supervisors tweaked its prohibition just last month.

As a former cigarette smoker, New Yorker Gary Smith is dismayed that his home state might OK smoking pot.

He knows research hasn’t tied smoking marijuana to lung cancer, which killed three cigarette smokers in his family and struck him 20 years after he quit; he’s been treated. But he fears the respiratory risks of marijuana smoking aren’t fully known.

“It’s crazy that the government, in order to raise (revenue from) taxes, they’re permitting people to suck this stuff into your lungs,” says Smith, 78, an accountant from Island Park.

Hawaii physician and state Rep. Richard Creagan feels no less strongly about cigarettes. The ex-smoker and Democrat from Naalehu this year unsuccessfully proposed all but banning them by raising the legal age to 100.

Meanwhile, he’d like Hawaii to legalize recreational marijuana, an idea that fizzled in the state Legislature this year.

Creagan, 73, thinks pot benefits people’s well-being more than it risks their health, and he expects non-smoking alternatives will reduce the risks. Plus, he figures legal marijuana could replace cigarette tax revenue someday.

“That coupling,” he says, “was sort of in my head.”

© 2019 The Associated Press. All rights reserved.

Smoking pot vs. tobacco: What science says about lighting up by Jennifer Peltz As more states make it legal to smoke marijuana, some government officials, researchers and others worry what