Jamieon Adams of Denver smokes pot at Civic Center Park in 2013. (Hyoung Change, Denver Post file)

Marijuana cough: Why do I cough while smoking cannabis?

Welcome to our Ask The Cannabist column. Clearly you have questions about marijuana, be it a legal concern, a health curiosity, a Colorado-centric inquiry or something more far-reaching. Check out our expansive, 100-question Colorado marijuana FAQ first, and if you’re still curious, email your question to Ask The Cannabist at askthecannabist@gmail.com.

Hey, Cannabist!
I’ve been smoking since I was 18, and I’ve never had an issue with coughing. Now at 37 years old, every time I take a pull/inhale, I start coughing and I can’t stop it! This has been going on for about two years now. People say coughing is good because it gets you higher, but it drives me absolutely nuts! I can’t enjoy my smoke the way I use to! Any advice? — Teaneck New Jersey Toker

Hey, Teaneck Toker!
Well, from a practical perspective, it might be time to take a break from smoking. You don’t like coughing as it takes away from your enjoyment, and the problem has been going on for two years. Since it isn’t stopping, it’s best to give your lungs a rest.

Since it’s not clear whether you are recreational or medical consumer, I can discuss the issues raised by your question — but I don’t want to recommend something that could get you in trouble. Are you a medical marijuana patient? In New Jersey medical marijuana is legal to qualifying patients and caregivers.

Outside the medical program, current New Jersey penalties for getting caught with pot possession come with a “disorderly person” charge. Even being under the influence of marijuana there is a misdemeanor crime with a possible punishment of six months in jail, a $1,000 fine and 5 years in probation among other possible fines and penalties. That reality won’t be changing anytime soon as current governor (and presidential hopeful) Chris Christie does not support reforming marijuana laws. He’s adamantly opposed to legalization, even.

But since you have a medical concern, I recommend discussing the following questions with a trusted professional on your health care team. How much do you smoke? How often? What are you smoking — flower, concentrates or both? Are you smoking for medical or recreational purposes? Get personal advice from a medical professional who knows your medical history and can assess your current condition and address your concerns.

For the cannabis you have been smoking, what do you know about its quality? Do you know the growing standards and conditions? Avoid smoking anything with visible mold or mildew — and consider asking your supplier about any possible pesticides used in its cultivation.

Among the limited number of medical studies on marijuana’s impact on the respiratory system, results are inconclusive. In a study published in 2006 and funded by the National Institute on Drug Abuse, the data analyzed from 1,200 subjects showed no connection between marijuana use and lung cancer, even with regular or heavy use of marijuana.

However, this 2013 study from the Division of Pulmonary and Critical Care Medicine at the University of California at Los Angeles summarizes, “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.”

I asked Dr. Donald Tashkin, marijuana and health researcher and emeritus professor of medicine at UCLA’s David Geffen School of Medicine, about your marijuana cough. Tashkin answered via email:

“Chronic cough (often accompanied by increased production of phlegm and wheezing, but not shortness of breath) occurs in over approximately 25 percent of habitual smokers of marijuana and resolves soon after cessation of marijuana use, provided that the marijuana smoker does not also smoke tobacco.  The precise amount of time before symptoms resolve after marijuana use is discontinued has not been carefully studied.”

Tashkin adds that it’s possible the cough “might be due to another cause, such as cough-variant asthma, gastro-esophageal reflux disease or parenchymal lung disease.”

Dr. Tashkin concluded by recommending that you see a doctor to evaluate the cause of your cough. Sorry to be a buzzkill, but I’m sure you agree that your health is too important to ignore. XO

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