Regular Pot Smoking Won't Kill, Kaiser Researchers Determine

David Perlman, Chronicle Science Editor

In one of the largest marijuana studies ever conducted, researchers have
concluded that regular pot smoking does not cause death, but that branding
its use a crime may itself pose a health hazard by exposing users to
criminals and violence.

And because marijuana use is so widespread in America today, the researchers
called for medical guidelines warning that pot smoking can lead to risky
sexual behavior, impaired driving ability and ultimately to a strong
dependence akin to drug addiction.

The researchers tracked the records of more than 65,000 Bay Area members
of the Kaiser Permanente health plan for an average of 10 years. Compared to
the members who had never used marijuana, they found no increase in deaths
among more than 14,000 of the patients who had said they were marijuana
users between 1979 and 1985.

People with AIDS were the only group of pot smokers found to have
significantly higher death rates than the other nonsmokers. But their
mortality was virtually the same as it was for AIDS patients who didn't smoke
marijuana. So although the association between marijuana and AIDS deaths is
clear, ``we really don't think it's a cause,'' said Dr. Stephen Sidney, who
headed the research group.

The report on marijuana use and mortality was published yesterday in the
April issue of the American Journal of Public Health. The researchers were
from Kaiser Permanente in Oakland and the University of California School of
Public Health in Berkeley.

An estimated 10 million Americans now use marijuana, and because at least
onequarter of them are teenagers, Sidney said it is crucial for doctors and
parents to recognize the need for credible advice about pot smoking.

``Our primary message should be `Don't use it, but if God forbid you do
use it, then don't drive or let anyone who smokes it drive, and remember that
marijuana can easily lead you into situations of risky sex,' '' said Sidney,
who has three children, ages 15, 12 and 7.

The report noted that while marijuana smoking does not cause death, pot
smokers make significantly more clinic visits for respiratory infections like
coughs, colds and flu than nonsmokers.

In one part of the study, the researchers compared the risk of death among
the marijuana users to deaths among cigarette smokers and those who consumed
three or more alcoholic drinks a day.

Mortality was highest of all for the cigarette smokers, but the mortality
risk among marijuana smokers and drinkers varied by gender.

Among women, those who smoked marijuana had a lower risk of death than
drinkers, while mortality was higher among men who smoked pot than it was
among those who drank regularly.

The researchers stressed throughout their report that the links they found
between pot use and deaths were associations but not an indication that
marijuana was a cause of death.

The report also touched on several politically charged political issues. It
said:

``While reducing the prevalence of drug abuse is a laudable goal, we must
recognize that marijuana use is widespread despite the longterm,
multibillion dollar War on Drugs.''

``The criminalization of marijuana use may itself be a health hazard,
since it may expose the consumer to violence and criminal activity.''

``Medical guidelines regarding its prudent use should be established, akin
to the commonsense guidelines that apply to alcohol use.''

Clinical research on possible medical uses for marijuana is badly lacking,
the researchers said, despite ``reasonable evidence'' for its medical
effectiveness in combating the nausea that hits people being treated for
cancer and AIDS, as well as in treating glaucoma.

That last point directly countered another marijuana argument published
yesterday in the Annals of Internal Medicine by members of the International
Drug Strategy Institute, an antidrug organization based in Topeka, Kan.

Dr. Eric A. Voth and Dr. Richard H. Schwartz said they studied the effects of
THC, or tetrahydrocanabinol, the active ingredient of marijuana, which is
legally available by prescription. The doctors said their study shows that
THC's medicinal benefits are better than smoking real marijuana.

``I don't see any advantage of smoking pot, any more than I would suggest
there's an advantage of smoking tobacco for weight control or anxiety,'' Voth
told the Associated Press.

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