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Indlæg: 19 jul 2016 08:52 
https://www.leafly.com/news/headlines/a ... nd-tobacco

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Cannabis doesn’t carry the sort of health hazards tobacco does, a majority of studies say. But that doesn't change the European habit of mixing the two. It’s something North American cannabis consumers don’t often do: Even cigarette smokers in Vancouver or L.A. tend smoke their flower pure, strictly separating nicotine and cannabinoids. So where does this difference come from?



To answer the question, let’s go back in time to the cannabis renaissance of the 1960s and ‘70s. Consumers in Europe at the time almost exclusively smoked hashish, often crumbling it into cigarettes, as hardly anyone was aware of the dangers of nicotine and smoking tobacco. The vast majority of cannabis consumers in the U.S., on the other hand, overwhelming had access only to dried flower, which could easily be used to roll pure joints.

These differences influenced the size of what was being rolled in North America and Europe. In the U.S. and Canada, pure “mini-joints” became the standard, while on the continent a king-size joint is preferred. A European-sized joint that contains only cannabis might contain 1.5 grams to 2 grams of flower — far too much for most. An American joint, on the other hand, contains about as much herb — about 0.2 grams to 0.5 grams — as a European mixed joint (often called a spliff in the U.S.), but without the nicotine. Scientists have even pinpointed the average amount of cannabis in an American joint at 0.32 grams. In Germany, the Netherlands, or Denmark, that amount of cannabis is typically mixed with another gram or so of tobacco, depending on personal preference.



Not only does consuming a cannabis–tobacco blend affect your health more than pure flower, it also complicates efforts to gauge the health effects of cannabis itself. The legalization debate often revolves around the dangers of "smoking," because almost every European study on cannabis is not about smoking it pure but about cannabis mixed with tobacco. Even in medical programs, little attention is paid to whether patients smoke pure. That means that Europeans who use cannabis alone has to justify the consequences of a substance that has little to do with cannabis.

Even without tobacco, smoking is the unhealthiest form of any medical application. Yet other, healthier forms of consumption, such as vaporization or edibles, seem to catch on much more slowly in Europe. That’s in part because tobacco has long been engrained in European culture; as cannabis grew in popularity among Europeans, that affected how people chose to consume. In other cultures, where cannabis has been part of everyday life for millennia, people consume orally or at least smoke cannabis pure.


Mixing tobacco into a joint increases the addictive risks immensely. Many casual users have only begun to smoke cigarettes because they use tobacco for their joints. "Without cannabis I have no problems, but I then smoke more cigarettes" — you’ll never hear such a statement from a pure-cannabis consumer. Doctors in Germany or the Netherlands treating cannabis patients are often unaware of this phenomenon and fail to advise patients to quit tobacco— or at least to separate the consumption of both drugs so the positive effects of cannabis remain intact. The unfortunate reality is that in most instances in Europe, the pairing of cannabis and tobacco simply isn’t discussed.

Last but not least, pure cannabis acts quite differently than a cannabis–tobacco blend. Patients report that the combination of nicotine and cannabis can lead to pain relief and relaxation, but very often they note fatigue as a negative side effect.


All these facts should be worrying enough for European cannabis fans to reflect on their consumption habits. To make things worse, there's the political aspect. Prohibitionists use the dangers of the legal drug nicotine to protest against legalization of cannabis: "How can we have ever stricter laws to control tobacco and at the same time legalize cannabis?"

Professor Donald Tashkin has been a leading American pulmonologists for decades. In the past he was a vocal supporter of cannabis prohibition. Tashkin was convinced that smoking cannabis flowers created a high risk of developing lung cancer or chronic obstructive pulmonary disease (COPD). At one point, he was convinced that cannabis and lung cancer had a causal relationship worse than tobacco.


But more recent evaluations of long-term studies, however, made him change his mind in 2009: "Early on, when our research appeared as if there would be a negative impact on lung health, I was opposed to legalization because I thought it would lead to increased use, and that would lead to increased health effects,” he has said. “But at this point, I'd be in favor of legalization. I wouldn't encourage anybody to smoke any substances, because of the potential for harm. But I don't think it should be stigmatized as an illegal substance. Tobacco smoking causes far more harm. And in terms of an intoxicant, alcohol causes far more harm."

If the legislators take their task to protect public health seriously, European studies that evaluate the risk potential of pure cannabis consumed in various forms (smoking, vaporizing, edibles) have to be undertaken. These studies should take the international state of research into account, focusing on safer ways of consuming.


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Indlæg: 19 jul 2016 10:48 
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Jeg stopper med at bruge tobak i mine joints den dag amerikanerne stopper med at være så pisse hykleriske.

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Umiddelbart vil jeg tro at det generelt ikke er særligt udbredt at brænde sin kokain af. Hvorfor gør du det?


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Indlæg: 20 jul 2016 00:25 
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Pestilence skrev:
Jeg stopper med at bruge tobak i mine joints den dag amerikanerne stopper med at være så pisse hykleriske.


Så kan du vidst roligt anskaffe dig et karton mere ..

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Indlæg: 20 jul 2016 08:25 
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Citat:
Cannabis doesn’t carry the sort of health hazards tobacco does, a majority of studies say.


Hvilke studier? At inhalere røg er notorisk usundt. De henviser måske til andre indtagelsesmetoder? Så er det lidt snyd, vil jeg sige :)
At bekymre sig om de skadelige effekter ved en smule tobak i joints, er i min bog ret hyklerisk.

Pestilence skrev:
Jeg stopper med at bruge tobak i mine joints den dag amerikanerne stopper med at være så pisse hykleriske.


Mennesket er hyklerisk af natur. Det er ikke kun amerikanerne :)

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Indlæg: 25 jul 2016 19:46 
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Citat:
Cannabis doesn’t carry the sort of health hazards tobacco does, a majority of studies say.


Hvilke studier? At inhalere røg er notorisk usundt. De henviser måske til andre indtagelsesmetoder? Så er det lidt snyd, vil jeg sige :)
At bekymre sig om de skadelige effekter ved en smule tobak i joints, er i min bog ret hyklerisk.




Præcis! Ligemeget hvad, så er det stadig fucking røg i dine lunger, og det vil være usundt om det så er plastik eller pot

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Indlæg: 26 jul 2016 11:21 
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Det bliver lidt meget sort/hvidt, gør det ikke? Alt kan gradbøjes i nuancer og udtalelser som: "Ligemeget hvad, så er det stadig fucking røg i dine lunger, og det vil være usundt om det så er plastik eller pot", betyder ikke, at den ene (plastik) ikke er tusindfold mere skadelig end den anden (pot).

Det er faktisk relativt dokumenteret, at cannabis rygning ikke er associeret med cancer i samme grad som tobaksrygning. Se fx:

http://www.ncbi.nlm.nih.gov/pubmed/23802821 - Ann Am Thorac Soc. 2013 Jun;10(3):239-47. doi: 10.1513/AnnalsATS.201212-127FR.
Effects of marijuana smoking on the lung.

"In summary, the accumulated weight of evidence implies far lower risks for pulmonary complications of even regular heavy use of marijuana compared with the grave pulmonary consequences of tobacco."

http://www.ncbi.nlm.nih.gov/pubmed/25587109 - Cancer Epidemiol Biomarkers Prev. 2015 Jan;24(1):15-31. doi: 10.1158/1055-9965.EPI-14-1026.
An epidemiologic review of marijuana and cancer: an update.

"The lung cancer studies largely appear not to support an association with marijuana use, possibly because of the smaller amounts of marijuana regularly smoked compared with tobacco."

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1277837/ - Harm Reduct J. 2005; 2: 21. Published online 2005 Oct 18. doi: 10.1186/1477-7517-2-21
Cannabis and tobacco smoke are not equally carcinogenic

"In conclusion, while both tobacco and cannabis smoke have similar properties chemically, their pharmacological activities differ greatly. Components of cannabis smoke minimize some carcinogenic pathways whereas tobacco smoke enhances some. Both types of smoke contain carcinogens and particulate matter that promotes inflammatory immune responses that may enhance the carcinogenic effects of the smoke. However, cannabis typically down-regulates immunologically-generated free radical production by promoting a Th2 immune cytokine profile. Furthermore, THC inhibits the enzyme necessary to activate some of the carcinogens found in smoke. In contrast, tobacco smoke increases the likelihood of carcinogenesis by overcoming normal cellular checkpoint protective mechanisms through the activity of respiratory epithelial cell nicotine receptors. Cannabinoids receptors have not been reported in respiratory epithelial cells (in skin they prevent cancer), and hence the DNA damage checkpoint mechanism should remain intact after prolonged cannabis exposure. Furthermore, nicotine promotes tumor angiogenesis whereas cannabis inhibits it. It is possible that as the cannabis-consuming population ages, the long-term consequences of smoking cannabis may become more similar to what is observed with tobacco. However, current knowledge does not suggest that cannabis smoke will have a carcinogenic potential comparable to that resulting from exposure to tobacco smoke.

It should be noted that with the development of vaporizers, that use the respiratory route for the delivery of carcinogen-free cannabis vapors, the carcinogenic potential of smoked cannabis has been largely eliminated"


Jeg tror OPs budskab er blevet mødt med lidt rigelig skepsis, blot fordi budskabet bryder med den meget indgravede tradition for blandingen af tobak og cannabis vi har i europa. Det er selvfølgelig lidt et paradigme skift, at anerkende at man måske ikke gør noget på den mest hensigtsmæssige måde, men det gør altså ikke informationen mindre valid.


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Indlæg: 27 jul 2016 08:35 
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Det er netop ikke sort og hvidt :)

Jeg kendte ikke til de studier, du har postet. Det er ikke et emne, jeg har kigget særligt dybt i. Men når de kommer med et postulat som "Cannabis doesn’t carry the sort of health hazards tobacco does, a majority of studies say." uden referencer, så ved man allerede der, at forfatterne ikke aner, hvad de snakker om. Jo mere skråsikkert et postulat, jo mere skepsis vil det blive mødt med. De kunne f.eks. have henvist til nogle af de studier, du postede for at underbygge deres påstand.

Men jeg synes stadig ikke, man skal bekymre sig om lidt tobak i joints, hvis man ikke ryger hele tiden. Og hvis man ryger joints hver dag, så er der måske nogle andre problemer, man skal forholde sig til i stedet. At ryge en cigaret én gang om ugen f.eks., er (sandsynligvis) ikke associeret med væsentligt øget risiko for cancer. Så vidt jeg har forstået, ved man ikke helt endnu, hvor lidt tobak man kan ryge helt uden øget risiko for cancer.
Fedt at der er en journal, der hedder harm reduction journal i øvrigt :D

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Indlæg: 27 jul 2016 09:15 
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Det bliver lidt meget sort/hvidt, gør det ikke? Alt kan gradbøjes i nuancer og udtalelser som: "Ligemeget hvad, så er det stadig fucking røg i dine lunger, og det vil være usundt om det så er plastik eller pot", betyder ikke, at den ene (plastik) ikke er tusindfold mere skadelig end den anden (pot).

Det er faktisk relativt dokumenteret, at cannabis rygning ikke er associeret med cancer i samme grad som tobaksrygning.

Jeg tror OPs budskab er blevet mødt med lidt rigelig skepsis, blot fordi budskabet bryder med den meget indgravede tradition for blandingen af tobak og cannabis vi har i europa. Det er selvfølgelig lidt et paradigme skift, at anerkende at man måske ikke gør noget på den mest hensigtsmæssige måde, men det gør altså ikke informationen mindre valid.


Jeg er glad for at der er én der kan se at DK's cannabis rygekultur ikke er specielt smart, når nu det er muligt at helt at undgå tobak. Det virker dog som om det er noget op ad bakke, mht. til at ændre indgroede vaner, og nok især når det drejer sig om noget så afhængighedsskabende som tobak.


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Indlæg: 27 jul 2016 11:51 
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Det skal ikke være nogen hemmelighed, at spørgsmål som disse rammer indenfor flere af mine interesse sfærer.

Jeg er enig i, at retorikken bliver meget skråsikker. Desværre tager man alt for ofte cannabis som værende "pure good" i disse miljøer. Som de også konkluderer i det 3. studie jeg linkede:
"It is possible that as the cannabis-consuming population ages, the long-term consequences of smoking cannabis may become more similar to what is observed with tobacco."

Hvad der virkelig ville være interessant, var et studie der så på cancer, emfysem, bronkitis og arteriosklerose incidens mellem amerikanere der identificere som "pure smokers" og europæere der identificere som "mixers". Naturligvis med forbehold for andre eksternale faktore.

Mht skadeligheden for tobak, tror jeg at en kurve for skadeligheden ville antage en meget sigmoid karakter i lavere doser, med en midterværdi omkring en pakke. Man skal ikke ryge ret mange cigaretter for at få en markant skadevirkning, hvor det at ryge mange cigaretter ikke vil have den samme grad af "skade per cigaret". Fx kigger dette studie lidt på det: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2865193/ - (Se: http://www.health.harvard.edu/mens-heal ... n-any-dose , for et let overskueligt format.)
Her konkluderes fx at lungekræft incidens øges 2.8 gange ved 1 - 4 cigaretter dagligt. Det gør det naturligvis ikke til endegyldig sandhed, men jeg tror man har en tendens til at undervurdere skadeligheden af selv et sporadisk forbrug af tobak. Vi kan dog sagtens blive enig om, at 2.8 gange ikke er meget, set i forhold til hvor få der får lunge kraft. Det er dog stadig en fordobling af risikoen. Eller at et par cigaretter om ugen heller ikke er livsfarligt, men dog efter min mening bestemt skadeligt.

Selvfølgelig er det her ikke et kæmpe problem ret sundhedsmæssigt, men objektivt set er det korrekt, at det lader til at det at ryge sin cannabis rent er forbundet med en hvis grad af mindre sundhedsfare sammenlignet med det at blande tobak i. Den helt store variabel er jo også ristning af tobakken, som ingen studier endnu forholder sig til.
Samtidig kan det blive et problem, hvis ikke man er opmærksom på denne forskel, hvis man skal udføre studier eller sammenligne resultater på et niveau, hvor cannabis skal betragtes som et lægemiddel.

Jeg smilte også, da jeg stødte på harm reduction jn. Jeg kendte den heller ikke. :) Den virker ret god og ganske gratis (jeg har ikke haft problem med adgang uden om akademia).


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