Sue  Gould,

Thanks for your interesting question. 

Let's start with tobacco which can be very detrimental to anyone's health, but even more dangerous for asthmatics who have sensitive airways.  The tobacco smoke is irritating to the airways and can cause an asthma attack.   A long term smoker develops small to medium sized airway disease, chronic mucus/sputum production, and a decrease in their pulmonary reserve.   Over time, these chronic changes can only aggravate a person's asthma. 

Cannibis, on the other hand, can cause widening of the airways within the lung that can last an hour.   This is the opposite of what happens during an asthma attack when the airways constrict (or narrow), with less air movement and resulting shortness of breath.  Some studies have shown that smoking cannabis can actually abort an asthma attack.  Some people have an allergy to the cannabis seed and this can potentiate an asthmatic attack.  This is the short term picture.  Long term use of cannabis causes chronic irritation of the airways, along with chronic mucus/sputum production.  There is also an effect on the small to medium sized airways, similar to tobacco smokers.  These chronic changes are detrimental to asthma and potentiate the disease along with further attacks.

So, in short:  Tobacco is dangerous to everyone, but more so in asthmatics.  Cannabis may have some short term benefit to an asthmatic who is having active bronchospasm (wheezing), but long term, has many dangers similar to tobacco.

From a medical point of view, both tobacco and Cannabis should be avoided.

Martin Cane, M.D.

Hi Sue:

Dr. Cane had some wonderful advice and you should pay close attention to what he is saying.

From a psychological standpoint, you should consider this: we are seeing more and more people who are getting "bad" cannabis and as such we are seeing more paranoia and even psychosis.  That means, these people are hallucinating -- hearing voices that are telling them to kill or hurt themselves, or worse yet, that someone is trying to kill them.

We cannot say for certain, since research (that is, controlled studies) are virtually impossible (unethical) to do.  You can't give a drug to a person just waiting to see if they will become psychotic.  While we know that there is a connection between cannabis and mental illness, that does not mean that cannabis causes mental illness. We cannot prove it, in any case. 

However, I have seen long-term users of marijuana develop paranoia and hallucinations and be hospitalized, and treated, and the psychosis stays, despite all efforts to help them.

Please tell her to be careful. I'm an old Hippie and we once believed that cannabis couldn't hurt you. Times have changed and it can cause irreparable harm.

Dr. Diana Walcutt, Licensed Psychologist

The Stress Masters