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>> "If marijuana use is implicated in cardiovascular diseases and deaths, then it rests on the health community and policy makers to protect the public." Like
by nxsynonym 9y ago
>> "If marijuana use is implicated in cardiovascular diseases and deaths, then it rests on the health community and policy makers to protect the public."
Like how the policy makers protect the public from Alcohol, tobacco, and over-the-counter meds?
Also a 1200 person study isn't really enough to draw any major conclusions from.
Of course ingesting anything substance of any kind frequently over a period of time is bound to be harmful to some degree. What we need is context and not one-off sensationalist studies that are used as propaganda fodder on either side of the debate.
- CJefferson 9y agoPolicy makers do put quite a lot of work into protecting us from alcohol, tobacco and over the counter meds. Also, 1200 people is a fairly huge study, plenty to get some quality statistics from. I'm not sure why you have been so offended by this research. It looks quite convincing to me, and fairly worrying.
- nxsynonym 9y agoI'm not offended. I encourage more studies to be done! 1200 is a large number of people, but not large relative to the number of people who consume regularly. What I'm railing against is "news" articles that don't contextualize or think critically about the studies that are being performed, and try to generate clicks through buzz-word filled headlines.
- phaed 9y agoRecognize that this knee jerk reaction is your brain's attempt at dismissing the study and move on.
- nxsynonym 9y agoIt's easy to dismiss studies that have a large number of caveats and no strict way of measuring use.
- dragonwriter 9y ago> 1200 is a large number of people, but not large relative to the number of people who consume regularly. Ratio of sample to population size is mostly irrelevant for statistics. The strength of conclusions from a sample is calculated based on an infinite population size.
- swasheck 9y agoI agree on your second point. 1200 people is a substantial population. However, we'd also need to read more about the details of the study to see how it was conducted and how controls were controlled and then, naturally, someone would have to reproduce the results using the same methodology. There are plenty of questions to be asked of this study, but blithely dismissing the sample size while attacking the government (and the recommendation that they do more to protect the populace) are not the first two holes to poke at this study.
- eric_bullington 9y ago> 1200 people is a fairly huge study, 1200 people is a huge, convincing study for a well-executed prospective, interventional study, like a clinical trial. This is a cross-sectional retrospective study, using merged data from several different sources. Retrospective, epidemiological studies are notoriously subject to bias, particularly ones like this one. Such retrospective studies are good for forming hypotheses about diseases in study populations (and often, intervention studies are not feasible), but they are often inadequate for testing these hypotheses. As the study authors say themselves, longitudinal studies are required to really draw strong inferences. I'd have to read the study to be sure, and it's been a long time since I formally studied or worked in epidemiology/biostatistics, but some of the numbers mentioned in this article look fairly unconvincing. For example, this study found very little association between tobacco use and metabolic syndome, which goes against most available evidence. Also, things like having insurance and being married are associated with a significant increase in metabolic syndrome (not sure if this is in line with existing research, but it sounds kind of counterintuitive).
- mbreese 9y agoGiven the current legal environment around marijuana use (I'm not sure what it's like in the UK), I doubt you'd be able to adequately control for other confounding variables in a study like this. For example, is there a skew in demographics between users and non users? Socio-economic status? Other health indicators? Diet? Pre-existing hypertension? (Were people self-medicating?) Lifestyle? What about delivery? Is this a smoking-in-general related effect or would other forms of consumption also have the same effect? 1200 people is a pretty large study, but from this writeup, it isn't clear that they would be able to completely single out cannabis as the sole factor. I'd have to read the fully paper to know more. That said -- it is a worrying concern and certainly a good enough reason to continue studying this potential effect. Hopefully they will be able to continue with lab based studies to try and find an underlying mechanism.
- dekhn 9y agoThe N of the study isn't the issue here. It's the large collection of other methodological details, such as self-reported survey data, and a lack of dose-response, that invalidate it for policy purposes. When you say it "looks quite convincing", are you qualified to judge it on its merits?
- CJefferson 9y agoI had a look, I'm not an expert in the area by any means, but at a reasonable glance it looks like a good study to me. Of course, it could be a giant fiddle (almost any experiment can be), but I try hard not to automatically assume studies which say what I like are good, and ones that say what I don't like are bad. I'm sure there will be more research in this area, now that there is not the threat of jail if people report on their usage.
- dekhn 9y agoTell ya what. As a homework assignment, can you do enough stats research to do a reasonable critique of the methodology?
- josinalvo 9y agoI am very interested in the answer key for this homework... In all seriousness, I'd love a breakdown, and references for further study (on how to read medical papers, or scientific papers in general)
- dekhn 9y agoI suggest starting with "Primer on Biostatistics" by Glantz https://www.amazon.com/Primer-Biostatistics-Seventh-Glantz-Paperback/dp/0071781501 https://www.amazon.com/Primer-Biostatistics-Seventh-Glantz-P... which contains the basics you need to know to do analysis of stats analysis. I haven't read it, but you'll probably want a book like https://www.amazon.com/Design-Studies-Medical-Research/dp/0470844957 https://www.amazon.com/Design-Studies-Medical-Research/dp/04... or https://www.amazon.com/Study-Design-Statistical-Analysis-Clinicians/dp/0521534070 https://www.amazon.com/Study-Design-Statistical-Analysis-Cli... realistically you need at least a master's degree in a quantitative field to get the time and knowledge required to evaluate studies like this. I see a lot of armchair "scientists" trying to evaluate studies, it's very common to see basic mistakes in evaluating papers.
- millzlane 9y ago>It looks quite convincing to me, and fairly worrying. That's how propaganda works. I know it's anecdotal, but I've been a 3 or more times a day (everyday) smoker for over 11.5 years and I'm an no where near the risk of my overweight family members. Blood pressure has been fine and I'm an no risk of hypertension. Demand more proof if you're convinced by this. Something smells fishy. I would like to know how Snoop, Willie, and Morgan are holding up. They must be ready to keel over with how they smoke.
- web_worker 9y agoAnd this is how confirmation bias works. 'Something about this study feels fishy... what about these anecdotes?' You did call yourself out for being anecdotal, so I'm sure you see it. As a fellow daily smoker I very much want to pick holes in this as well.
- millzlane 9y agoTrue and I agree. But I think lifestyle choice has a lot to do with this sickness. I was never conscious about my health until about 3 years ago when I quit "smoking" and began only to vaporize. Maybe that has something to do with it. But I really think a lot of this sickness are results of a sedentary lifestyle. Something we knew was bad when we discovered sitting was the new cancer.
- web_worker 9y agoTotally with you there. I've been oscillating between smoking and vaporizing, and running and not running lately. I feel best, by a gigantic margin, when I am vaping and running >4x / week. I guess that's kind of a no brainer. I think you are correct that this has a lot to do with other factors. I know some lazy stoners, and I've been that lazy stoner.
- moxious 9y agoHold on now, picking individual celebrity examples has some serious survivorship bias on its own. We don't hear from the ones who did experience early mortality. Cannabis is a hard topic for Americans to talk about, because it's been so often unfairly demonized in the past, there's a pro-cannabis camp that sometimes won't admit any downside to it, fearing "Reefer Madness" style FUD which has been very common for decades. But is it really all that surprising that smoking could be bad for your health, irrespective of what it is? My take would be that people shouldn't be persecuted for this, but that it's straightforwardly obvious that any smoking (and doubly so an unregulated plant that would reasonably be expected to vary tremendously in quality depending on supplier) -- would be harmful.
- TallGuyShort 9y agoThe difference between how you're treated for consuming alcohol (which as far as I'm aware is objectively more dangerous - and more immediately so to other people - than marijuana) and for consuming marijuana in most places is pretty ridiculous, to the point of almost seeming like satire. Alcohol also has a pretty significant (don't think it's quite this significant, granted) effect on coronary health, not to mention liver damager, etc. And yet the reason for the difference is that we just accepted alcohol prohibition doesn't work. But guess how easily you can get marijuana, even where it's illegal at the state and local level too... To be clear, I think this is good research to be done. Better to know about this than not, obviously, and I hope it leads people to make some better life decisions. But I'm also anticipating that this is going to get held up as, "You see? It's the devil's grass!" in a very illogical and inconsistent way.
- VT_Drew 9y ago>But guess how easily you can get marijuana, even where it's illegal Guess how easily you can get any drug.....even in prisons. If we can't keep drugs out of prison then what chance is there to keep it out of the general public? The war on drugs is over. Drugs won. Legalize them all, provide accurate labeling, and tax it. There is nothing left to "debate".
- TallGuyShort 9y ago>> The war on drugs is over. Drugs won. I'd say they're winning, and will almost certainly continue to. I really wish, for many reasons, we could move that to past tense like you did.
- dgreensp 9y agoJust because consuming something regularly for 12 years raises your blood pressure doesn't mean it's a danger to the public that needs to be illegal. You might as well criminalize junk food. In a context of overblown fear and stigma around marijuana, the article should have at least put some perspective on the health risks, rather than having the message of, "Some people say marijuana has no health risks, but according to a study, there are. Be worried."
- dgreensp 9y agoActually, stoners are probably consuming a lot of processed food. Hmmm....
- dgreensp 9y agoJust because consuming something regularly for 12 years raises your blood pressure doesn't mean it's a danger to the public that needs to be illegal. You might as well criminalize junk food. In a context of overblown fear and stigma around marijuana, the article should have at least put some perspective on the health risks, rather than having the message of, "Some people say marijuana has no health risks, but according to a study, there are. Be worried."
- Overtonwindow 9y agoNot quite. I'm a lobbyist in the health care industry, and policy related to alcohol and tobacco are designed to meet a very different policy goal from over the counter medications. The latter is a can of worms beyond the scope of this but let's narrow to alcohol and tobacco. First, alcohol is not as highly regulated as you might think. The contents of the bottle are not strongly regulated, and producers are actually forbidden under the law from listing the ingredients on the bottle.[3] How do you know you're drinking true vodka, and not a mixture of grain alcohol or something worse? Without testing there is no way to find out, and the government doesn't do that unless there is a strong reason to do so. The Alcohol and Tobacco Tax and Trade Bureau regulates the label, they regulate those labels a LOT, but along with advertising that's about it.[4] The rest of alcohol regulation is devoted to keeping it away from those under 21, with some PSA's on pregnancy, alcoholism, etc. Tobacco is almost as highly regulated. Science has proven, more than we can count, and completely indisputable, that tobacco use leads to serious, life threatening health concerns.[5] The best policy position to take on tobacco is to ban it, but they don't.[6] The next best thing would be to set standards that limit the chemicals in tobacco.[0][8] They don't. (Incidentally tobacco products weren’t even regulated by the FDA until 2009)[8] This leaves regulation on packaging, advertising [7], where you can smoke, but has become largely focused on keeping it away from children, and reducing smoking. So in a way the government might seem to be protecting us from tobacco, but in reality, they don't. Marijuana on the other hand is so highly regulated[1] that it's been extremely difficult to even study it[2] to determine what health affects it might have. I'm not saying one is better than the other, but morality has driven policy on marijuana for so long that the policy research on marijuana legalization, is only now beginning to gain substance. Until marijuana is studied as much as tobacco and alcohol, all policy decisions will be unfairly biased by morality and personal opinion. [0]. http://www.lung.org/stop-smoking/smoking-facts/whats-in-a-cigarette.html?referrer=https://www.google.com/ http://www.lung.org/stop-smoking/smoking-facts/whats-in-a-ci... [1]. https://www.fda.gov/downloads/aboutfda/centersoffices/officeofmedicalproductsandtobacco/cder/ucm498077.pdf https://www.fda.gov/downloads/aboutfda/centersoffices/office... [2]. https://www.nytimes.com/2014/08/10/us/politics/medical-marijuana-research-hits-the-wall-of-federal-law.html https://www.nytimes.com/2014/08/10/us/politics/medical-marij... [3]. http://www.foodpolitics.com/2010/11/nutrition-labeling-of-wine-beer-and-spirits-a-regulatory-morass/ http://www.foodpolitics.com/2010/11/nutrition-labeling-of-wi... [4]. https://www.ttb.gov/consumer/labeling_advertising.shtml https://www.ttb.gov/consumer/labeling_advertising.shtml [5]. https://betobaccofree.hhs.gov/health-effects/smoking-health/index.html https://betobaccofree.hhs.gov/health-effects/smoking-health/... [6]. http://www.denverpost.com/2008/08/13/why-congress-wont-ban-tobacco/ http://www.denverpost.com/2008/08/13/why-congress-wont-ban-t... [7]. http://www.cbsnews.com/news/fdas-graphic-cigarette-labels-rule-goes-up-in-smoke-after-us-abandons-appeal/ http://www.cbsnews.com/news/fdas-graphic-cigarette-labels-ru... [8]. http://gizmodo.com/the-fda-is-cracking-down-on-american-spirit-and-so-call-1726983463 http://gizmodo.com/the-fda-is-cracking-down-on-american-spir...
- elif 9y agoyea i had a hard time making sense of the paper, probably my fault. it seemed like they didn't control for obesity, and it also seemed like alcohol had a much stronger correlation. I would love to hear from someone that can properly read it though. I also find it interesting that the odds for marijuana users are 1.05 per year but, e.g. marriage is 1.17, alcohol 1.84 etc, yet the conclusion is about marijuana. Bias: I am a non-drinking, unmarried, low-blood pressure, no cholesterol, extremely underweight stoner https://www.omicsonline.org/pdfdownload.php?download=open-access/relationship-between-years-of-marijuana-use-and-the-four-main-diagnosticcriteria-for-metabolic-syndrome-among-united-states-adults-2155-6105-S11-017.pdf&aid=86076 https://www.omicsonline.org/pdfdownload.php?download=open-ac...
- austinheap 9y agoThe headline could have been... > Marriage greater risk to heart than cannabis: report But that wouldn't sell as well.
- TheTruestKyle 9y agoHah! In seriousness, I'm curious of its relationship to anxiety. Anxiety seems to increase with my intake of cannabis. I'm also trying to do 5 projects at once which increases stress.
- mlvljr 9y ago>> yea i had a hard time making sense of the paper, probably my fault >> Bias: I am a ... underweight stoner I see :V
- artemisyna 9y ago1200 person study is a pretty big study. That said, the authors of the study themselves listed some pretty big caveats. http://www.oregonlive.com/health/index.ssf/2017/08/study_linking_cardiovascular_d.html http://www.oregonlive.com/health/index.ssf/2017/08/study_lin...
- FungalRaincloud 9y agoThose are some pretty big caveats...
- John_Cena 9y agoThen the problem is not with the creators of the trials, but those who are reporting them with insufficient characterizing information.
- heroprotagonist 9y agoA 1213 participant study, of which 72.5% are assumed still alive. So ~334 people. Maybe the other 879 people will live longer happier lives. Source: http://journals.sagepub.com/doi/10.1177/2047487317723212 http://journals.sagepub.com/doi/10.1177/2047487317723212
- priam 9y agoIt's a self-fulfilling prophecy study
- laythea 9y agoDon't forget coffee. I need the government to protect me from my cups, every day. What to do???
- kolbe 9y agoAdding soda, bike riding, swimming, TV/internet/gaming addiction... Sometime freedom means the freedom to make what others think are bad decisions.
- vilmosi 9y ago> Like how the policy makers protect the public from Alcohol, tobacco, and over-the-counter meds? ... Yes? Those are all heavily regulated and/or massively taxed.
- priam 9y ago>>> "Also a 1200 person study isn't really enough to draw any major conclusions from." You can draw strong conclusions off of a smaller sample size. This study is not conclusive, and the sensationalized headlines aren't helping.
- legohead 9y agoI was looking for more information about the #s involved. Is my risk going from .00001% to .00003%? What am I really looking at, here?
- elipsey 9y agoThere are a couple of things about this study that are puzzling to me. First, I'm a little confused about how to interpret the finding that hypertension related deaths increased, but not stroke or heart attack; I have not been aware of hypertension as a common direct cause of death. For example the textbook "Cardiology Explained" states that: "If untreated, hypertension has serious consequences, including renal disease, myocardial infarction (MI), and cerebrovascular accident." Most general literature that I can recall reading seemed to similarly characterize high blood pressure as a risk factor for other causes of death. Second, the author of study states "Support for liberal marijuana use is partly due to claims that it is beneficial and possibly not harmful to health." Who is supporting "liberal marijuana use"? Support for "liberal use" is not implied by support for decriminalization. I hope that press release has left out some sort of context or attribution for this, because it is making it hard for me to take the study seriously. Here is the meat of the abstract, and a link to the full text of the study: http://journals.sagepub.com/doi/pdf/10.1177/2047487317723212 http://journals.sagepub.com/doi/pdf/10.1177/2047487317723212 "Method: We linked participants aged 20 years and above, who responded to questions on marijuana use during the 2005 US National Health and Nutrition Examination Survey to data from the 2011 public-use linked mortality file of the National Center for Health Statistics, Centers for Disease Control and Prevention. Only participants eligible for mor- tality follow-up were included. We conducted Cox proportional hazards regression analyses to estimate hazard ratios for hypertension, heart disease, and cerebrovascular mortality due to marijuana use. We controlled for cigarette smoking and other relevant variables. Results: Of the 1213 eligible participants 72.5% were presumed to be alive. The total follow-up time was 19,569 person-years. Adjusted hazard ratios for death from hypertension among marijuana users compared to non-marijuana users was 3.42 (95% confidence interval: 1.20–9.79) and for each year of marijuana use was 1.04 (95% confidence interval:1.00–1.07). Conclusion: From our results, marijuana use may increase the risk for hypertension mortality. Increased duration of marijuana use is associated with increased risk of death from hypertension. Recreational marijuana use potentially has cardiovascular adverse effects which needs further investigation."
- ajross 9y ago> Like how the policy makers protect the public from Alcohol, tobacco, and over-the-counter meds? Well... yeah. Exactly like that. State and local laws cover when and where you can drink and smoke. The federal FDA extensively regulates OTC medications. HHS and ATF have extensive jurisdiction here too. And of course there is a very large private sector component made up of groups like AA, AlAnon and MADD that seek to address some of the social problems substance abuse causes. I mean, you seem to be invoking sarcasm here, but in fact these substances are very heavily regulated right now. You need to expect weed to fall into the same category as it becomes legal and better-studied.
- nxsynonym 9y agoI didn't mean to imply it shouldn't be regulated. From the way the article worded it made it seem like it was policy makers duty to protect the public from "reefer madness". Yes those other things have regulations and restrictions, but how many alcohol related deaths have there been this year? How many heroin over doses that stemmed from prescription abuse? My point is that context is necessary for these types of studies.