Does cannabis smoking predispose to lung bulla formation?

Asian Cardiovasc Thorac Ann. 2014 Jan;22(1):65-71. doi: 10.1177/0218492313478954. Epub 2013 Sep 5.


Objective: The data of a consecutive series of habitual marijuana smokers were retrospectively evaluated and compared with that of non-marijuana smokers to assess differences between the 2 groups.

Methods: 13 consecutive habitual marijuana smokers were referred for treatment of spontaneous pneumothorax. The demographic, clinical, radiological, and pathological findings of these patients were reviewed and compared with 140 non-marijuana smokers treated for the same pathology at the same time.

Results: Bullae were seen in 8/13 (62%) and 110/140 (78%) of marijuana smokers and non-marijuana smokers, respectively. However, when patients less than 35-years old were considered, the incidence of bulla was higher in marijuana smokers than non-marijuana smokers (7/10 vs. 3/10, p < 0.05). The pathological findings showed a greater presence of inflammatory cells in specimens from marijuana smokers than those of non-marijuana smokers (8/11 vs. 2/42, respectively, p < 0.05). No significant differences in hospital stay and clinical outcome were registered between the 2 groups.

Conclusions: Despite the fact that we were unable to demonstrate that marijuana had a causal role in the development of emphysema, our study showed that marijuana smokers had a higher incidence of inflammatory cells in pathological specimens, which may favor lung injury, thus predisposing to bulla formation.

Keywords: Blister; Lung diseases; Marijuana smoking; Pneumothorax; Pulmonary emphysema.

MeSH terms

  • Adult
  • Biopsy
  • Blister / diagnosis
  • Blister / etiology*
  • Humans
  • Male
  • Marijuana Abuse / complications*
  • Marijuana Smoking / adverse effects*
  • Middle Aged
  • Pneumothorax / diagnosis
  • Pneumothorax / etiology
  • Pneumothorax / therapy*
  • Pulmonary Emphysema / diagnosis
  • Pulmonary Emphysema / etiology*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Tomography, X-Ray Computed
  • Young Adult