5 ms·

Policy 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

Policy 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 ago
I'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 ago
  Recognize that this knee jerk reaction is your brain's attempt at dismissing the study and move on.
  - nxsynonym 9y ago
    It'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 ago
I 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 ago
Given 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 ago
The 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 ago
  I 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 ago
    Tell ya what. As a homework assignment, can you do enough stats research to do a reasonable critique of the methodology?
    - josinalvo 9y ago
      I 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 ago
        I 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 ago
  And 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 ago
    True 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 ago
      Totally 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 ago
  Hold 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 ago
The 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 ago
Just 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 ago
  Actually, stoners are probably consuming a lot of processed food. Hmmm....
dgreensp 9y ago
Just 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 ago
Not 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...

nxsynonym 9y ago

I'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 ago
Recognize that this knee jerk reaction is your brain's attempt at dismissing the study and move on.
- nxsynonym 9y ago
  It'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 ago

I 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 ago

Given 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 ago

The 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 ago
I 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 ago
  Tell ya what. As a homework assignment, can you do enough stats research to do a reasonable critique of the methodology?
  - josinalvo 9y ago
    I 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 ago
      I 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 ago
And 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 ago
  True 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 ago
    Totally 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 ago
Hold 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 ago

The 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 ago

Just 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 ago
Actually, stoners are probably consuming a lot of processed food. Hmmm....

dgreensp 9y ago

Overtonwindow 9y ago

Not 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...