Drug agencies report that the majority of cannabis in the England is smoked and combined with tobacco i.e. in a ‘joint’, although exact figures are hard to come by, and there is very little research in this area. Research tends to focus on America and the USA experience where tobacco is not used.
Evidence of the link between smoking cigarettes and ill health has been documented for more than 50 years. Wynder and Graham's (1950) study of 650 men with lung cancer found that 95% had been smoking for 25 years or more. In 1951, Sir Richard Doll and Sir Austin Bradford Hill's study examined 5,000 patients in British Hospitals, of which 1,357 men with lung cancer, 99.5% were smokers.
Global research since that time irrefutably states the considerable negative impact of smoking cigarettes on health and life expectancy, with one in two smokers dying from the affects of smoking, and overall 106,000 people dying last year alone in the UK.
There is no completely safe tobacco and around 80% of the health risks come from inhaling the smoke. Bronchitis, chronic pulmonary disease, carbon monoxide and lung cancer all come from inhaling the smoke, while also reducing the amount of vitamins in your body (ASH,2006). Also, from a deprivation perspective, if two parents smoke cigarettes and cannabis, it is likely they will be spending in excess of £3,500 a year on cigarettes (if purchased legally), plus up to £1,500 a year on cannabis. This raises fundamental child poverty issues in cases where a family is existing on benefits or other low income.
Smoking cannabis ‘joints’ should really be seen as the same as smoking a large cigarette, in that it is harmful to health. In some ways the public perception of this issue is the same as in the early days of smoking, in that the health impacts were not taken seriously by either health professionals or the public, and took many years to filter down into society's consciousness.
The negative effects of smoking cannabis on mental health and memory has been well documented, while it is interesting to note that the effects of the tobacco in ‘joints’ has been almost entirely ignored, it is therefore time to combine what we know of the affects of each drug in combination. There is a lot of evidence linking mild and mild-to-moderate cannabis use with schizophrenia, loss of short-term memory, anxiety and depression.
While the general population is aware of the health impact of smoking, it appears that certain sections of the community view the use of cannabis as benign and its use is seen as acceptable and normalised amongst certain sections of the population. This perception should be challenged, not least because of the development of new, hybrid forms of cannabis (e.g. super-skunk’) which contain much higher THC content than traditionally encountered in the 1970s, 1980s and early 1990s.
Those who use cannabis in this form and want to quit have access to behavioural support through specialist services; although support is sketchy and many do not know it is available.
These clients have had no recourse to medical interventions like Nicotine Replacement Therapy (NRT), as in cigarette use, with ‘cold turkey’ or reduction technique being the only options.
Nicotine Addiction and Cannabis Use
The physically addictive part of a cigarette is nicotine, which is more addictive than either heroin or crack cocaine. However it is relatively harmless, the dangerous parts of a cigarette are tar, carbon monoxide, plus the 4000+ chemicals, some of which are carcinogenic.
The majority of cannabis users are addicted to often very high levels of nicotine without probably being aware, as one large cannabis joint is equal to approximately 5 to 12 cigarettes, but this is difficult to measure exactly as all are individually rolled. There is also strong psychological addiction associated with cannabis use. Simply put, you get 5- 12 times the amount of nicotine, tar, carbon monoxide and the 4000+ additional chemicals.
Furthermore cannabis is smoked differently from cigarettes, usually with no effective filter and cannabis burns at a higher temperature than cigarettes, damaging the delicate structure of the lungs, and joints are generally inhaled more deeply and held in the lungs for far longer than a cigarette.
Cigarettes are notoriously difficult to give up with only a 2- 3% success rate for those quitting without support, mostly due to the nicotine withdrawal symptoms. Using NRT (or Zyban) on prescription as an aid to quitting plus behavioural support, is nearly five times more successful than going it alone in the long term.
Many quit attempts fail where the user smokes both cigarettes and cannabis. The user often stops smoking cigarettes, but cannabis consumption goes up to compensate for the nicotine carvings. Often, the smoker doesn’t understand that the nicotine addiction is being maintained whilst combining nicotine with cannabis. Thus, the physical withdrawal symptoms never go away, and are often further exacerbated.
Withdrawal symptoms from cannabis smoked and combined with tobacco has similar challenges to that of cigarettes, while in some cases the withdrawal symptoms can be more extreme than that of giving up smoking cigarettes, using NRT can help relieve some of the unpleasant withdrawal symptoms and it provides an opportunity to break the link between cannabis and nicotine.
The use of NRT is sometimes recommended for withdrawal symptoms by FRANK, the UK national drugs helpline, while the majority of front line drug agencies and public are unaware that it could be helpful.
A minority of cannabis users may be aware of the benefits of NRT but are reluctant to seek out support from their GP or local Stop Smoking Services, while the majority of Smoking Cessation staff don't have the experience or confidence in working with this client group and probably would require additional training.
Usage of Cannabis
Figures from the ‘The Home Office, Drug Misuse Declared: Findings from the 2004/2005 Crime Survey’, state that for that year, 29.7% of 16-59 year olds reported using cannabis, and 23% of 16- 24 year olds. Overall drug misuse generally was higher amongst men (IPCP: LAA People Project: Key findings to date, October 2006). Other research has made a link between cigarette and cannabis use potentially leading to the use of other stronger substances, i.e. the gateway effect.
Cannabis and the law
Cannabis is illegal; it's a Class C drug. If you’re caught with cannabis the police will always take action.
Possession Information in this section from FRANK: www.talktofrank.com
If you’re caught with even a small amount of cannabis on you, you can be arrested. What the police will do depends on the circumstances and how old you are. Usually, you’ll get a warning and the police will confiscate the drug and if you’re under 18, your parent or guardian will also be contacted.
The police are more likely to arrest you if: you are blatantly smoking in public and/or have been caught with cannabis before. If you continue to break the law, you can end up with a criminal record which could affect your chances of getting a job. It could also affect whether you can go on holiday to some countries.
The maximum penalty for possession is two years in prison plus an unlimited fine.
Supply
Dealing is a serious offence. In the eyes of the law, this includes giving drugs to friends. People who grow cannabis in their homes or carry large amounts on them also risk being charged with intent to supply.
The maximum penalty for supply is 14 years in prison plus an unlimited fine.
Did you know?
Drug driving is as illegal as drink driving. You could go to prison, get a heavy fine or be disqualified.
Allowing people to take cannabis in your house or any other premises is illegal. If the police catch someone smoking cannabis in a club they can prosecute the landlord, club owner or person holding the party.
Using cannabis to relieve pain is also an offence. Possession is illegal whatever you’re using it for.
To speak to a friendly advisor, call FRANK on 0800 77 66 00
Article by George Gallagher (Islington PCT Smoking Cessation Advisor) and Martin Lever (Public Health Consultant).
No comments:
Post a Comment