A preview of Dr. Tashkin’s forthcoming review appears on the American Thoracic Society news website here. It reads:

Dr. Tashkin found that regular smoking of marijuana by itself causes visible and microscopic injury to the large airways that is consistently associated with an increased likelihood of symptoms of chronic bronchitis that subside after cessation of use. He also found that the evidence does not indicate that habitual use of marijuana leads to significant abnormalities in lung function when assessed either cross-sectionally or longitudinally, except for possible increases in lung volumes and modest increases in airway resistance of unclear clinical significance.

The author finds no clear link between marijuana use and the development of COPD or lower respiratory tract infections. In addition, “findings from a limited number of well-designed epidemiological studies do not suggest an increased risk for the development of either lung or upper airway cancer from light or moderate use, although evidence is mixed concerning possible carcinogenic risks of heavy, long-term use,” Dr. Tashkin notes. “In summary, the accumulated weight of evidence implies far lower risks for pulmonary complications of even regular heavy use of marijuana compared to the grave pulmonary consequences of tobacco.”

The full paper will be available later this month.

In May, presenters at the annual meeting of the American Academy for Cancer Research reported that subjects who regularly inhale cannabis smoke possess no greater risk of lung cancer than do those who consume it occasionally or not at all — according to an analysis of six case-control studies, conducted between 1999 and 2012, involving over 5,000 subjects (2,159 cases and 2,985 controls) from around the world.

Last year, clinical data published in the Journal of the American Medical Association (JAMA) reported that subjects’ exposure to moderate levels of cannabis smoke, even over the long-term, is not associated with significant adverse effects on pulmonary function.

Vaporizers, which heat marijuana to a point where cannabinoid vapors form, but below the point of combustion, reduce subjects’ intake of potentially hazardous combustible compounds. In several clinical trials, investigators have concluded that vaporization is a “safe and effective” cannabinoid delivery mode that “does not result in exposure to combustion gases.” Researchers also report that vaporization results in higher plasma concentrations of THC compared to smoked cannabis.

Former Disney pop star Miley Cyrus recently offered her two cents on alcohol and marijuana use. In her June 18 interview with Rolling Stone, the 20-year-old singer said, “I think alcohol is way more dangerous than marijuana. People can be mad at me for saying that, but I don’t care. I’ve seen a lot of people spiral down with alcohol, but I’ve never seen that happen with weed. As long as it isn’t illegal, there are far more dangerous things.”

Cyrus also stated that “it’s legal in the state of California.” While Miley is right that marijuana is safer than alcohol, she is mistaken about the Sunshine State’s cannabis laws. Recreational use is still prohibited, and possession of an ounce or more can lead to arrest.

Then, Gov. Hassan issued a formal statement indicating that she intends to sign the bill after it is approved one last time by the House and Senate. She said the compromise “addresses the concerns that I have heard and expressed throughout this session, and provides the level of regulation needed for the use of medical marijuana…. I encourage the full legislature to pass this compromise so I can sign this legislation into law.”

Sadly, Gov. Hassan was not willing to agree to any significant changes, so only minor improvements were made by the committee. Home cultivation will remain a felony under all circumstances, and patients will have no legal protections until ID cards are issued (which could take up to 19 months).

Despite these imperfections, we are very pleased that New Hampshire will finally be moving forward with implementation of a medical marijuana law.

The amended bill calls for the creation of four state-sanctioned marijuana dispensing facilities to produce and distribute cannabis to state-qualified patients who possess a physician’s recommendation. Patients diagnosed with one of approximately twenty qualifying conditions — including cancer, hepatitis C, amyotrophic lateral sclerosis, muscular dystrophy, Crohn’s disease, or multiple sclerosis — would be permitted to legally possess up to than two-ounces of cannabis. Under the proposed law, patients must obtain cannabis only from a state-licensed facility. Qualified patients will not be provided with any legal protections to possess or use cannabis prior to the establishment of such facilities.

As originally passed by the House, the measure allowed for qualified patients to have the option to grow their own cannabis. The measure also allowed for physicians to recommend cannabis for the treatment of post-traumatic stress. Both provisions were stripped from the bill by the Senate at the request of newly-elected Democrat Gov. Maggie Hassan.

Gov. Hassan is expected to approve the reconciled version of HB 573. A commission is expected to be put in place to oversee the implementation of the law as soon as the bill is passed.

New Hampshire will become the 19th state to allow for the limited, legal use of medical cannabis and the final New England state to do so.

Lt. Gov. Mead Treadwell

On June 14, Lt. Governor Mead Treadwell certified a ballot initiative application that would put the question of whether to tax and regulate marijuana like alcohol up to state voters. In order to appear on next year’s ballot, the initiative must receive 30,169 signatures from qualified voters.

The proposal would create state-regulated marijuana stores, cultivation facilities, and the option for Alaska’s legislature to create a Marijuana Control Board tasked with overseeing the industry. It would also allow adults to grow up to six marijuana plants.

Petition sponsor Tim Hinterberger stated that advocates hope to finish collecting signatures by January in order to get the petition on the primary ballot.

If the proposal passes, it would help to clear up Alaskans’ confusion over some of the nation’s most contradictory marijuana laws. In 1975, the Alaska Supreme Court ruled that possession of less than four ounces in the home was protected from criminal sanctions by the state constitution’s right to privacy. However, in 2006, the legislature passed a bill criminalizing the possession of even small amounts of marijuana. Meanwhile, the state is one of 18 that allows patients to access medical marijuana.

Mason Tvert, a spokesman for MPP, is quoted in the Huffington Post as saying that this proposal is not a “blanket protection for marijuana possession… In order to have a system where individuals can go to the store, buy an ounce of marijuana, drive home, and enjoy it at home, it is necessary to make up to an ounce of marijuana entirely legal.”