BMJ  2003;327:165 (19 July), doi:10.1136/bmj.327.7407.165-a

Letter

Comparing cannabis with tobacco

Those who start taking cannabis young have the greatest problems

EDITOR—Henry et al compare cannabis with tobacco.¹ Through the North East Council for Addictions (NECA) I have contact with cannabis users in the north east of England. Many young people (including 1% of schoolchildren) smoke at least five (up to 15) spliffs daily or inhale from "buckets." Thus they obtain high concentrations of cannabis smoke containing all the constituents of tobacco smoke (except nicotine), including carbon monoxide, bronchial irritants, and carcinogens. Young people may start smoking at the age of 8 years, and more and more smokers are continuing for longer—into their 40s and 50s.

Unlike tobacco (nicotine) cannabinoids also have adverse psychiatric effects. A large amount of evidence shows that young and adolescent users are especially vulnerable to these effects.^{2 3} Those starting to use cannabis while in their early teens are more likely to suffer intellectual and emotional impairment; escalate to weekly or daily use; become dependent; progress to other illicit drugs; become anxious, depressed, and suicidal; and be involved in delinquency and crime than those starting later.^{4 5}

Department of Psychiatry, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP c.h.ashton{at}ncl.ac.uk

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Competing interests: None declared.

References

1. Henry JA, Oldfield WLG, Kon OM. Comparing cannabis with tobacco. BMJ 2003;326: 942-3. (3 May.)[Free Full Text]
2. Fergusson DM, Horwood LJ, Swain-Campbell N. Cannabis and psychosocial adjustment in adolescence and young adulthood. Addiction 2002;97: 1123-35.[CrossRef][ISI][Medline]
3. Rey JM, Sawyer MG, Raphael B, Patton GC, Lynskey M. Mental health of teenagers who use cannabis. Results of an Australian Survey. Br J Psychiatry 2002;180: 216-21.[Abstract/Free Full Text]
4. Swift W, Hall W, Copeland J. One year follow-up of cannabis dependence among long-term users in Sydney, Australia. Drug Alcohol Dependence 2000;59: 309-18.[CrossRef][ISI][Medline]
5. Swift W, Hall W, Teeson M. Cannabis use and dependence among Australian adults: results from the national survey of mental health and wellbeing. Addiction 2001;96: 737-48.[CrossRef][ISI][Medline]

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Relevant Article

Comparing cannabis with tobacco

John A Henry, William L G Oldfield, and Onn Min Kon
BMJ 2003 326: 942-943. [Extract] [Full Text] [PDF]

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