Marijuana smoking: Health and socioeconomic impact in middle-aged and elderly adults

Background: Scant data exists on the health and socioeconomic implications of marijuana smoking in middle age and elderly adults. Objective: To determine the association between smoking of marijuana with respiratory symptoms, fixed airflow limitation, perceived health status, social and work functioning. Method: 5291 people from the population, aged 40 years and older answered questions on respiratory history, tobacco and marijuana smoking, quality of life and economic impact, and performed spirometric tests before and after the administration of 200ug of salbutamol. The associations between smoking with airflow limitation and patient outcomes were examined by multivariable logistic regression models. Results: Tobacco(T) smokers and tobacco and marijuana(T+M) smokers had increased risk, aOR(95% confidence interval, CI) for: a) respiratory symptoms including wheeze 1.77(1.48-2.10)(T) and 2.24(1.76-2.8)(T+M) and; b) chronic airflow limitation, (95%CI), 2.09(1.73-2.52) for (T) and 2.30 (1.71-3.09) for (T+M); c) a reduced self-perceived health status, 1.71(1.22-2.34)(T+M) and 1.60(1.24-2.05)(T). T+M smokers also had reduced social activities. Marijuana and tobacco interacted synergistically on the risk of COPD and symptoms. Marijuana(M) smoking was related to missing work for income, OR 1.40( 1.06-1.85) (T+M) and OR 2.41( 1.61-3.64),(M). Conclusion: Tobacco smoking alone but not marijuana alone was associated with increased chronic respiratory symptoms and COPD; dual smoking of tobacco and marijuana synergistically increasing the risk. Marijuana smoking whether alone or with concurrent tobacco smoking had adverse social or economic impacts in the middle aged and elderly population.