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Are marijuana users at an increased risk of suffering serious complications should they contract the novel coronavirus?

As the COVID-19 pandemic drones on, many are now aware that older adults and people with certain underlying medical conditions are at a higher risk for severe illness from COVID-19. The same is also true for cigarette smokers, according to the Centers for Disease Control and Prevention (CDC). But does that increased risk also apply to those who smoke marijuana, a substance that has become increasingly legal in states across the nation in recent years?

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Fox News spoke to Dr. Albert Rizzo, the chief medical officer at the American Lung Association, to find out. Read on for a look at his answers below.

The following has been edited for length and clarity:

Fox News: How does smoking marijuana affect your lungs or airways?

Dr. Rizzo: What happens to your airways when you smoke cannabis is that it causes some degree of inflammation, very similar to bronchitis, [and] very similar to the type of inflammation that cigarette smoking can cause.

Fox News: Does this put users more at risk for COVID-19 complications?

Rizzo: Yes, because you now have some airway inflammation, and if you get the SARS-CoV-2 virus infection on top of that, your risk of complications can go up. The CDC includes smokers and vapers at higher risk of complications from COVID-19.

Fox News: Are marijuana users and cigarette smokers at equal risk for severe COVID-19 complications?

Rizzo: My view on this is that any substance that is combusted and then inhaled exposes the airways and the lungs to particles and toxins that lead to some degree of airway inflammation similar to inflammation that may be seen in those with chronic asthma or COPD. Those two patient groups have been shown to have an increased risk of complications from COVID-19, so it would suggest to me that cannabis smokers, like cigarette smokers, may have the potential for more complications if they get infected.

Whether there are similar risks between cigarette smokers versus cannabis users has been hard to determine for a number of reasons. First of all, because of the federal laws around cannabis, it has been difficult to do large-scale cohort studies to study the effects on the airways over time.

Smoking marijuana can lead to airway inflammation.
(iStock)

There is also the confounding effect that many cannabis users are also cigarette smokers so it becomes difficult to see which substance led to a particular finding in the lungs.

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There are other distinctions as well. The depth of inhalation and breath-holding of cannabis smokers differs in general from many cigarette smokers.  Also, cannabis burns at a much, much lower temperature than a commercially made cigarette, and for that reason, the person is inhaling a certain amount of unburnt plant material. This material can irritate the lungs in the same manner as ragweed, birch and oak pollen does for those allergic to those allergens.

Fox News: Are occasional marijuana users and chronic marijuana users at equal risk for COVID-19 complications? 

Rizzo: “Chronic” cannabis smoking, defined as daily use, damages the lungs over a period of time and the end result is a degree of chronic bronchitis not unlike that seen in patients with COPD or chronic asthma. We do know that [a] more intense and longer duration of cigarette usage seems to carry with it more risk of certain diseases, such as lung cancer. There has not been evidence to date that chronic cannabis use leads to chronic diseases lung COPD or lung cancer. But remember the aphorism, “absence of evidence is not evidence of absence.”

Fox News: For those who use marijuana to help with anxiety during these uncertain times, what would you recommend they do instead?

Rizzo: Some of the same things in this regard apply to cigarette smokers. Cigarette smokers often find that anxiety and stress are [some] of the main hurdles that keep them from quitting. Quitting during stressful times means you need to rely on other modalities, [which may] include getting into a regular exercise routine, employing relaxation and meditation techniques, and certainly trying to build a support network around you, either with household members or with friends. Discussing options with your health care provider is paramount.

Fox News: Are marijuana users at an increased risk even if they are following social distancing guidelines and being as safe as possible?

Rizzo: No, the risk of getting the infection is not heightened by the act of smoking itself. The risk of contracting the infection is increased if the smoking is done in a gathering of individuals, especially if there is sharing of any materials that may contain or transfer respiratory droplets from one individual to another. In other words, sharing the joint among friends is a great way to get the infection from one of your friends who may not know they have the disease. The social distancing measures, along with frequent hand washing and avoiding individuals known to be infected, is the best way to prevent getting the infection.

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Fox News: How can people keep their lungs as healthy as possible during this time? Are there any specific tips?

Rizzo: Good advice for lung health includes the main recommendations for general good health — regular exercise, proper sleep, proper hydration and maintaining normal body weight. Specific to lung health are key behavioral issues, such as not smoking or vaping, avoiding indoor and outdoor air pollution, and getting yearly influenza vaccines as well as pneumococcal vaccines when appropriate.