Department of Respiratory Medicine, Waikato Hospital, Hamilton, New Zealand.
Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Addiction. 2021 Jan;116(1):182-190. doi: 10.1111/add.15075. Epub 2020 Apr 28.
Cannabis is one of the world's most widely used recreational drugs and the second most commonly smoked substance. Research on cannabis and the lungs has been limited by its illegal status, the variability in strength and size of cannabis cigarettes (joints), and the fact that most cannabis users also smoke tobacco, making the effects difficult to separate. Despite these difficulties, the available evidence indicates that smoking cannabis causes bronchitis and is associated with changes in lung function. The pattern of effects is surprisingly different from that of tobacco. Whereas smoking cannabis appears to increase the risk of severe bronchitis at quite low exposure, there is no convincing evidence that this leads to chronic obstructive pulmonary disease. Instead, cannabis use is associated with increased central airway resistance, lung hyperinflation and higher vital capacity with little evidence of airflow obstruction or impairment of gas transfer. There are numerous reports of severe bullous lung disease and pneumothorax among heavy cannabis users, but convincing epidemiological data of an increased risk of emphysema or alveolar destruction are lacking. An association between cannabis and lung cancer remains unproven, with studies providing conflicting findings.
大麻是世界上使用最广泛的消遣性毒品之一，也是第二大最常吸食的物质。由于大麻的非法地位、大麻卷烟（大麻烟卷）的强度和大小存在差异，以及大多数大麻使用者也吸食烟草，使得大麻对肺部的影响难以分离，因此对大麻和肺部的研究受到了限制。尽管存在这些困难，但现有证据表明，吸食大麻会引起支气管炎，并与肺功能的变化有关。其影响模式与烟草的影响模式惊人地不同。虽然吸食大麻似乎在相当低的暴露水平下增加了患严重支气管炎的风险，但没有令人信服的证据表明这会导致慢性阻塞性肺疾病。相反，大麻的使用与中央气道阻力增加、肺过度充气和肺活量增加有关，而气流阻塞或气体转移受损的证据很少。有大量关于重度大麻使用者发生严重大疱性肺疾病和气胸的报告，但缺乏肺气肿或肺泡破坏风险增加的令人信服的流行病学数据。大麻与肺癌之间的关联仍然没有得到证实，研究结果相互矛盾。
