Underner M, Urban T, Perriot J, Peiffer G, Meurice J-C
Unité de tabacologie, service de pneumologie, centre de lutte antituberculeuse CLAT 86, CHU La Milétrie, BP 577, pavillon René-Beauchant, 86021 Poitiers cedex, France.
Rev Mal Respir. 2013 Apr;30(4):272-85. doi: 10.1016/j.rmr.2013.01.013. Epub 2013 Mar 19.
Cannabis is the most commonly smoked illicit substance in many countries including France. It can be smoked alone in plant form (marijuana) but in our country it is mainly smoked in the form of cannabis resin mixed with tobacco. The technique of inhaling cannabis differs from that of tobacco, increasing the time that the smoke spends in contact with the bronchial mucosal and its impact on respiratory function. One cigarette composed of cannabis and tobacco is much more harmful than a cigarette containing only tobacco. In cannabis smokers there is an increased incidence of respiratory symptoms and episodes of acute bronchitis. Cannabis produces a rapid bronchodilator effect; chronic use provokes a reduction in specific conductance and increase in airways resistance. Studies on the decline of Forced Expiratory Volume are discordant. Cannabis smoke and tetrahydrocannabinol irritate the bronchial tree. They bring about histological signs of airways inflammation and alter the fungicidal and antibacterial activity of alveolar macrophages. Inhalation of cannabis smoke is a risk factor for lung cancer. Stopping smoking cannabis will bring about important benefits for lung function. This should encourage clinicians to offer patients support in quitting smoking.
在包括法国在内的许多国家，大麻是最常被吸食的非法物质。它可以以植物形式（大麻）单独吸食，但在我国，它主要是以与烟草混合的大麻树脂形式被吸食。吸入大麻的技术与烟草不同，这增加了烟雾与支气管黏膜接触的时间及其对呼吸功能的影响。一支由大麻和烟草组成的香烟比一支只含烟草的香烟危害大得多。大麻吸食者呼吸道症状和急性支气管炎发作的发生率增加。大麻会产生快速的支气管扩张作用；长期使用会导致比气道传导率降低和气道阻力增加。关于用力呼气量下降的研究结果不一致。大麻烟雾和四氢大麻酚会刺激支气管树。它们会引发气道炎症的组织学迹象，并改变肺泡巨噬细胞的杀菌和抗菌活性。吸入大麻烟雾是肺癌的一个危险因素。停止吸食大麻将给肺功能带来重要益处。这应鼓励临床医生为患者提供戒烟支持。
