Cannabis increased the risk of primary spontaneous pneumothorax in tobacco smokers: a case-control study
2017
Previous smaller case series suggested that
cannabis smokingmay cause spontaneous
pneumothorax, but this finding remains controversial. We investigated the possible association between
smoking tobaccoand
cannabisand the risk of having a primary spontaneous
pneumothoraxin a large, homogeneous cohort of young, healthy individuals.In a case-control study, we prospectively investigated young (≤40 years) patients admitted in Western Denmark from 2009 to 2016 with their first episode of primary spontaneous
pneumothorax. Baseline characteristics and smoking habits including both tobacco and
cannabiswere obtained from questionnaires presented on admittance. We compared our findings with those of a population-based control group matched by age, sex and geographical area. Calculated
odds ratioswere compared using the
Fisher's exact testfor small frequencies and the χ2 test or the Mann-Whitney test for larger frequencies.A total of 416
patients participated(male/female ratio = 3.9). We observed a significantly increased risk of primary spontaneous
pneumothoraxin daily smokers compared with female never smokers (
odds ratio = 8.10, 95% confidence interval: 4.61-14.14, P < 0.001) and male never smokers (
odds ratio = 4.85, 95% confidence interval: 3.23-7.19, P < 0.001). The combination of smoking both
cannabisand tobacco in men increased the risk of spontaneous
pneumothoraxsignificantly (
odds ratio = 8.74, 95% confidence interval: 4.30-19.51, P < 0.001). In contrast, the
cannabishabits of female patients did not differ from those of the Danish population in general.Combined smoking of tobacco and
cannabissignificantly aggravates the risk of having a primary spontaneous
pneumothoraxin young men compared to both never smokers and daily smokers.
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