Marijuana doesn’t harm lung function, study found
By LINDSEY TANNER
CHICAGO (AP) — Smoking a joint once a week or a bit more apparently doesn’t harm the lungs, suggests a 20-year study that bolsters evidence that marijuana doesn’t do the kind of damage tobacco does.The results, from one of the largest and longest studies on the health effects of marijuana, are hazier for heavy users – those who smoke two or more joints daily for several years. The data suggest that using marijuana that often might cause a decline in lung function, but there weren’t enough heavy users among the 5,000 young adults in the study to draw firm conclusions.
Still, the authors recommended “caution and moderation when marijuana use is considered.”
Marijuana is an illegal drug under federal law although some states allow its use for medical purposes.
The study by researchers at the University of California, San Francisco, and the University of Alabama at Birmingham was released Tuesday by the Journal of the American Medical Association.
The findings echo results in some smaller studies that showed while marijuana contains some of the same toxic chemicals as tobacco, it does not carry the same risks for lung disease.
It’s not clear why that is so, but it’s possible that the main active ingredient in marijuana, a chemical known as THC, makes the difference. THC causes the “high” that users feel. It also helps fight inflammation and may counteract the effects of more irritating chemicals in the drug, said Dr. Donald Tashkin, a marijuana researcher and an emeritus professor of medicine at the University of California, Los Angeles. Tashkin was not involved in the new study.
Study co-author Dr. Stefan Kertesz said there are other aspects of marijuana that may help explain the results.
Unlike cigarette smokers, marijuana users tend to breathe in deeply when they inhale a joint, which some researchers think might strengthen lung tissue. But the common lung function tests used in the study require the same kind of deep breathing that marijuana smokers are used to, so their good test results might partly reflect lots of practice, said Kertesz, a drug abuse researcher and preventive medicine specialist at the Alabama university.
The study authors analyzed data from participants in a 20-year federally funded health study in young adults that began in 1985. Their analysis was funded by the National Institute on Drug Abuse.
The study randomly enrolled 5,115 men and women aged 18 through 30 in four cities: Birmingham, Chicago, Oakland, Calif., and Minneapolis. Roughly equal numbers of blacks and whites took part, but no other minorities. Participants were periodically asked about recent marijuana or cigarette use and had several lung function tests during the study.
Overall, about 37 percent reported at least occasional marijuana use, and most users also reported having smoked cigarettes; 17 percent of participants said they’d smoked cigarettes but not marijuana. Those results are similar to national estimates.
On average, cigarette users smoked about 9 cigarettes daily, while average marijuana use was only a joint or two a few times a month – typical for U.S. marijuana users, Kertesz said.
The authors calculated the effects of tobacco and marijuana separately, both in people who used only one or the other, and in people who used both. They also considered other factors that could influence lung function, including air pollution in cities studied.
The analyses showed pot didn’t appear to harm lung function, but cigarettes did. Cigarette smokers’ test scores worsened steadily during the study. Smoking marijuana as often as one joint daily for seven years, or one joint weekly for 20 years was not linked with worse scores. Very few study participants smoked more often than that.
Like cigarette smokers, marijuana users can develop throat irritation and coughs, but the study didn’t focus on those. It also didn’t examine lung cancer, but other studies haven’t found any definitive link between marijuana use and cancer.
By KRISTEN WYATT, Associated Press
DENVER — Colorado has become the third state to ask the U.S. Drug Enforcement Administration to reclassify marijuana in way that allows doctors to prescribe it as a medical treatment.
The head of Colorado’s Department of Revenue, which oversees the state’s booming medical marijuana business, made the request in a letter sent Dec. 22. It wasn’t released to the public until Wednesday because of the Christmas holiday.
The letter says the discrepancy between state law and federal drug law, which does not permit medicinal uses of marijuana, is problematic.
Last month, the governors of Washington and Rhode Island also asked that the government list marijuana as a Schedule 2 drug, like morphine and oxycodone.
Gov. Nikki Haley said she will let federal deadlines slip by and not accept millions in federal funds to help South Carolina set up its own health insurance exchange.
Health insurance exchanges, the centerpiece of federal health care reform, are online marketplaces, to be set up by each state, where the uninsured could compare insurance plans from private insurance companies and buy the one that best fits their needs. Uninsured people who meet certain federal poverty guidelines could buy coverage using federal tax credits.
The exchanges are scheduled to open in 2014 when the health care law goes into full effect. If a state has not made progress by Jan. 1, 2013, the federal government will step in.
But Haley and Tony Keck, whom Haley appointed to head the state’s Department of Health and Human Services, say the federal plan is not the right fit for South Carolina.
“The governor remains an equal opportunity opponent of ObamaCare, the spending disaster that South Carolina does not want and cannot afford,” said Rob Godfrey, Haley’s spokesman. “She and Tony Keck are focused on finding South Carolina solutions that provide our state with the most health at the least cost.”
Democrats say Haley is playing politics with an important issue that affects millions of South Carolinians. Other Republican governors, including Texas Gov. and GOP presidential candidate Rick Perry, also are saying they will not accept the money.
“If South Carolina would put half the effort into figuring out how to do this versus being opposed to it, we would be light years ahead in making sure people could get health care coverage they need,” said Rep. Gilda Cobb-Hunter, D-Orangeburg, who sponsored a bill this past session to set up a state health exchange.
“Governor Haley and all these people spouting the rhetoric have good health coverage,” Cobb-Hunter said. “The people who don’t have a place at the table, their voices are not being heard.”
Twenty-one percent of South Carolinians under age 65 are not insured, according to a 2004 survey by the state Department of Insurance, meaning they do not have private insurance or public insurance such as Medicaid or Medicare. An updated study is being conducted now for the department.
Keck said his opposition to applying for the money is that federal rules for the new exchanges are still not clear. And that’s making officials in many states hesitant to accept money and agree to yet-to-be-determined rules and regulations.
First Posted: 8/26/11 06:24 PM ET Updated: 8/26/11 06:24 PM ET
When addressing the challenge of changing behavior, Marjorie Hill says it’s easy to blame the victim.
But when it comes to dealing with HIV and AIDS, Hill says, it’s more complicated.
“We think that personal responsibility is important and we certainly encourage it,” she said. “But when you look at the numbers and understand the epidemiology, the most common factor that those 33 million people who have the disease share is poverty. Poverty doesn’t transmit HIV, but certainly being in a situation where someone has less access to information, resources, education and power — those are factors that influence HIV.”
That’s what GMHC, the world’s first provider of HIV and AIDS prevention, care and advocacy, works to change, Hill said.
Hill previously worked as the assistant commissioner for HIV in New York City’s Health Department, where she oversaw contracts for HIV and AIDS patients worth around $400 million. GMHC has a comparatively small $32 million budget, but Hill says she feels more connected with people at her current job.
She’s regularly in contact with people who have just found out they’re HIV positive, received a hot meal from GMHC’s pantry, won a court battle with help from the organization’s legal team or gone to their first job interview in 10 years and gotten positive feedback.
“We really do believe in an individual’s innate capacity to rise above difficult situations with support,” Hill says. “We build self-esteem, and help build resiliency.
Hill’s days are filled with meetings designed to further her organization’s reach and expand the number of people it can help.
The first half of Hill’s most recent Friday was spent discussing an initiative designed to reduce hospital visits, talking to an intern about careers in psychology, meeting with a board member about funding opportunities and planning a retreat for the board of directors to help them become better GMHC ambassadors.
Hill notes the undeniable progress that has been made since GMHC was founded in 1981. The organization went from providing people a way to die with dignity to getting them the first retroviral medications and now to helping them thrive.
“Over the last ten years that possibility of hope has transformed into giving individuals living with HIV and AIDS a chance to live productive lives,” Hill says. “It’s not a picnic. But it’s a very different disease than it was even 15 years ago.”
But progress is a double edged sword.
“In some ways, success is the biggest challenge,” Hill says. “Ten years ago, 20 years ago, you could almost not turn on a television or read a newspaper when there wasn’t something about AIDS. Now most Americans live their lives thinking that it’s no longer an issue. That’s a problem when there’s 1.2 million Americans living with HIV today.”
Hill takes heart in the efforts of roughly 1,000 GMHC volunteers who prepare meals, conduct mock interviews for job seekers and provide free legal services.
“They make this job great,” she said. “These are people who want to change the tide of the epidemic. We still have a lot of work to do.”
To find out more about GMHC visit the organization’s website.
Starting as soon as March, consumers could have a better handle on such questions, under new rules aimed at decoding the fine print of health insurance plans.
To make it easier for consumers to make apples-to-apples comparisons between plans, the summary will also include a breakdown estimating the expenses covered under three common scenarios: having a baby, treating breast cancer and managing diabetes.
Officials likened the new summary to the “Nutrition Facts” label required for packaged foods.
“If you’ve ever had trouble understanding your choices for health insurance coverage . . . this is for you,” Donald Berwick, a top official at the Department of Health and Human Services, said at a news conference announcing the proposal.
“Instead of trying to decipher dozens of pages of dense text to just guess how a plan will cover your care, now it will be clearly stated in plain English. . . . If an insurer’s plan offers subpar coverage in some area, they won’t be able to hide that in dozens of pages of text. They have to come right out and say it.”
Industry representatives said complying could prove onerous for insurers. “Since most large employers customize the benefit packages they provide to their employees, some health plans could be required to create tens of thousands of different versions of this new document — which would add administrative costs without meaningfully helping employees,” Robert Zirkelbach, press secretary for the industry group America’s Health Insurance Plans, said in a statement.
Insurance shoppers would also have to keep in mind that their actual premiums could change after they finalized their application, particularly in the case of plans for individuals, which can continue to adjust benefits based on detailed analysis of members’ health history over the next three years. (After 2014, the health-care law will essentially limit insurers to considering only three questions about applicants: how old they are, where they live and whether they smoke.)
The regulation, which is subject to a 60-day public-comment period, essentially fleshes out details of a mandate established by the the health-care law. But it also clarifies a question that the law left somewhat ambiguous: How soon into the application process can shoppers get the summary from insurers?
The regulations would require insurers to provide the summary on request, rather than waiting until someone applies for a policy or pays an application fee, a position that drew praise from consumer advocates.
“If consumers are really going to be able to compare their options, they should be able to easily get this form for any plan that they would like to consider,” said Lynn Quincy, senior health policy analyst for Consumers Union, the nonprofit publisher of Consumer Reports.
In addition to supplying the summary on demand, insurers would have to automatically provide it before a consumer’s enrollment, as well as 30 days before renewal of their health coverage. Plans must also notify members of any significant changes to their terms of coverage at least 60 days before the alterations take effect.
The summary form, which can be sent by e-mail, must be no longer than four double-sided pages printed in 12-point type. In addition to listing a plan’s overall premiums, co-pays and co-insurance amounts, it must include charts specifying the out-of-pocket costs for a range of specific services. A copy can be viewed at www.healthcare.gov/news/factsheets/labels08172011b.pdf.
While turning down one federal handout last week, the administration of Kansas Gov. Sam Brownback was applying for a different one.
No, thanks: $31.5 million for implementing the new federal health care law.
Please remit: $6.6 million to promote marriage.
The Kansas Department of Social and Rehabilitation Services is seeking $2.2 million a year for three years to pay for counseling that encourages unwed parents to marry. Free marriage licenses would be given to those who do.
State officials portrayed the grant request as the state’s first major marriage initiative aimed at reducing child poverty.
In giving up the $31 million, the governor said that every state should prepare for less federal cash, given that so many questions are swirling about government spending.
So why ask for marriage money?
Kansas Sen. Anthony Hensley, a Topeka Democrat, said the Brownback team is picking grants based on how they fit with its worldview.
Turning down the $31 million made a statement opposing President Barack Obama’s health care initiative, Hensley said. Promoting marriage was another matter for the Republican governor, he said.
“When it benefits their philosophical ideology, everything is fine,” Hensley said. “Where it doesn’t fit in or goes against them — either from a policy or political standpoint — then the federal money isn’t OK.”
Brownback’s staff didn’t detail why one grant would be more acceptable than the other, but it outlined how Kansas decides which grants to seek and which to forgo.
“The administration doesn’t have a blanket policy regarding grants. … Each potential grant and the federal requirements that come along with them are evaluated on a case-by-case basis with an increased watchful eye toward long-term mandates with short-term funding streams,” according to statements released to The Star.
Asked if other grants had been rejected, Brownback’s staff said it’s more accurate to say the state has declined to apply for some grants.
The state, for example, isn’t pursuing a slice of the $900 million that the federal government will give out over the next five years to help communities reduce chronic diseases such as diabetes and heart disease.
Though the Naperville, Ill.-based anti-gay group Americans For Truth About Homosexuality (AFTAH) recently lost their 501(c)3, tax-exempt organizational status, the group, officially designated as a hate group by the Southern Poverty Law Center last year, is keeping busy with a new campaign to uphold the federal ban against gay blood donors.
AFTAH’s campaign, called “Keep the Gay Blood Ban” or “KGB²,” was announced last Friday. The campaign urges individuals to contact their senators and congressmen “to put the safety of Americans — and a pristine blood supply — ahead of the demands of the selfish Homosexuality Lobby.” The group urges, further, for Congress to embark on an “investigation into the health hazards of homosexual behaviors (just as the government studied the dangers of smoking).”
As AFTAH president Peter LaBarbera hints at, the U.S. Department of Health and Human Services has taken steps in the last year toward dismantling the gay blood ban, which has been on the books since 1983, according to the Washington Independent. In 2010, some 40 members of U.S. Congress, led by Sen. John Kerry (D-Mass.) and Rep. Mike Quigley (D-Ill.), called for the department to lift the ban. Just last month, the department announced that they had begun a comprehensive evaluation of doing just that.
LaBarbera lashes out against Kerry and Quigley for ignoring “the politically incorrect reality is that male-on-male sex and the ‘gay’ sexual culture are extremely high-risk due directly to the dangerously perverse and unsanitary acts – and unprecedented promiscuity — practiced by ‘men who have sex with men.'” With its new campaign, LaBarbera vows to present the “harsh, shocking realities of homosexual sexual behavior,” and is getting started with a number of “graphic and vulgar descriptions of homosexual acts” excerpted throughout his post.
The existing ban prohibits any man who has sex with another man even once since 1977 from donating blood and has sometimes resulted in donors who are “effeminate” being turned away from donation centers — as 22-year-old Aaron Pace experienced in Gary, Ind., last month.
In a statement released in late July, Quigley said that he, alongside Kerry would “continue to push for a behavior-based screening process both in the name of fairness and a safer blood supply.”
Current law requires that all donated blood be tested for HIV and other infectious diseases as it is. A 2010 study by the Williams Institute estimated that, if the gay blood donor ban would be lifted, the nation’s blood supply would be increased by more than 200,000 pints per year.
For the first time in nearly two decades, students in New York City’s public middle and high schools will be required to take sex-education classes beginning this school year, using a curriculum that includes lessons on how to use a condom and the appropriate age for sexual activity.
The new mandate is part of a broader strategy the Bloomberg administration announced last week to improve the lives of black and Latino teenagers. According to city statistics, those teenagers are far more likely than their white counterparts to have unplanned pregnancies and contract sexually transmitted diseases.
“It’s obviously something that applies to all boys and all girls,” said Linda I. Gibbs, the deputy mayor for health and human services. “But when we look at the biggest disadvantages that kids in our city face, it is blacks and Latinos that are most affected by the consequences of early sexual behavior and unprotected sex.”
The change will bring a measure of cohesion to a patchwork system of programs largely chosen by school principals.
It will also bring to New York the roiling national debate about what, exactly, schools should teach students about sex.
Nationwide, one in four teenagers between 2006 and 2008 learned about abstinence without receiving any instruction in schools about contraceptive methods, according to an analysis by the Guttmacher Institute, which studies reproductive health. As of January, 20 states and the District of Columbia mandated sex and H.I.V. education in schools. An additional 12 states, New York included, required H.I.V. education only, according to a policy paper published by the institute.
New York City’s new mandate goes beyond the state’s requirement that middle and high school students take one semester of health education classes. The city’s mandate calls for schools to teach a semester of sex education in 6th or 7th grade, and again in 9th or 10th grade, suggesting they use HealthSmart and Reducing the Risk, out-of-the-box sets of lessons that have been recommended since 2007. A city survey of principals last year found that 64 percent of middle schools were using the HealthSmart curriculum.
For the Bloomberg administration, which last week announced a three-year, $130 million initiative to improve the lives of young minority men in the city, the sex-education mandate joins a number of other public health efforts — like the mayor’s push to reduce residents’ intake of salt and sugary sodas — that have sometimes been criticized as interventionist. It is also unusual because the city does not often tell schools what to teach.
“We have a responsibility to provide a variety of options to support our students, and sex education is one of them,” the chancellor, Dennis M. Walcott, said in an interview on Monday.
Parents will be able to have their children opt out of the lessons on birth-control methods. City officials said that while there would be frank discussions with students as young as 11 on topics like anatomy, puberty, pregnancy and the risks of unprotected sex, the focus was to get students to wait until they were older to experiment. At the same time, knowing that many teenagers are sexually active, the administration wants to teach them about safe sex in the hopes of reducing pregnancy, disease and dropouts.
Some are already preparing for a backlash.
“We’re going to have to be the bridge between the chancellor’s requirements and the community,” said Casimiro Cibelli, principal of Middle School 142 in the Baychester section of the Bronx, where many of the students come from immigrant, religious families with traditional views on sex. “Hopefully, we’ll allay their concerns because of their trust in us.”
At Mr. Cibelli’s school, the current semester-long health course does not stray from subjects like nutrition and physical fitness.
The new classes, which will be coeducational, could be incorporated into existing health education classes, so principals will not have to scramble to find additional instructional time. The classes would include a mix of lectures, perhaps using statistics to show that while middle school students might brag about having sex, not many of them actually do; group discussions about, for example, why teenagers are often resistant to condoms; and role-playing exercises that might include techniques to fend off unwanted advances.
Schools that have not been offering sex education — the number is unclear because the city’s Department of Education has not kept a tally, a spokeswoman said — can hire a teacher to do it or assign the task to one who is already on the staff. The department will offer training sessions before the start of classes Sept. 8.
Some New Yorkers of older generations remember explicit sex-education classes with frank talk about libido and demonstrations of how to use a diaphragm.
In 1987, the state mandated the adoption of an H.I.V./AIDS curriculum in every school. For students in the city, that has meant at least five class sessions each year, from kindergarten through 12th grade. In those classes, younger students are taught to avoid touching open wounds, and older ones are talked to about sex, but not necessarily about preventing pregnancies.
Opposition from religious groups and school board members eventually defeated a city mandate approved in the 1980s for a sex-education curriculum. But a survey by NARAL Pro-Choice New York in 2009 found that 81 percent of city voters thought sex education should be taught in public schools.
High schools in New York have been distributing condoms for more than 20 years. In the new sex-education classes, teachers will describe how to use them, and why, going where some schools have never gone before. To others, though, the topic will be familiar territory.
At John Dewey High School in Gravesend, Brooklyn, 10th graders already take a nine-week course called Human Sexuality, which the school’s health teachers designed some years ago and which covers many of the same topics that the city will require.
Some schools have relied on nonprofit or community groups like Planned Parenthood and the Door to teach their sex-education classes, an arrangement that is likely to continue once the new policy takes effect.
Mary Cheng, a health teacher at Murry Bergtraum High School in Lower Manhattan, said she devoted two months of students’ required five-month health class to sex education, combining lessons from the recommended high school curriculum with materials of her own. Ultimately, it will be up to schools to design the lessons; they will have until the beginning of the second semester to begin the classes.
“We will work with our schools and school communities to ensure they are prepared,” Mr. Walcott said.