Cardiovascular and Respiratory Effects of Cannabis Use by Route of Administration: A Systematic Review.

Aim: Knowledge of the cardiovascular and respiratory effects of cannabis use by route of administration is unclear. This evidence is necessary to increase clinical and public health awareness given the recent trend in cannabis legalization, normalization, and surge in the availability and usage of various forms of cannabis products. Methods: Search was conducted in Web of Science, ProQuest, Psych INFO, Scopus, Embase, and Medline databases, and subsequently in the references of retrieved articles. Peer-reviewed articles published between 2009 and 2023, that reported on cardiovascular and respiratory effects of cannabis use by route of administration were included. Studies with no report of the route of administration and combined use of other illicit substances were excluded. The review was guided by Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Results: Of the 1873 articles retrieved, 42 met inclusion criteria encompassing six case reports, 21 reviews, and 15 empirical studies. Four administration routes were identified: smoking, vaping, oral ingestion, and dabbing. Smoking was the most common route of administration and was associated with both respiratory effects, such as bronchitis, dyspnea, and chronic obstructive lung disease, and cardiovascular effects including tachycardia, ventricular arrhythmias, and myocardial infarction. Cannabis edibles were associated with minimal respiratory effects. Tachycardia was the most common cardiovascular effect and was associated with all routes of administration. Conclusion: Cannabis use does cause cardiovascular and respiratory effects, but the conclusion remains tentative of the cardiovascular and respiratory effects by route of administration due to methodological limitations of the studies.

Depression, Sleep Health & Sociodemographic Correlates in a Nationwide Survey: Implications for Depression Treatment During the COVID-19.

Purpose: The COVID-19 pandemic has had a profound impact on mental health worldwide, with depression and sleep problems among the most common issues experienced by many individuals. Depression can lead to sleep problems, which can increase the risk of developing depressive symptoms. However, it is unclear which United States (US) sub-population was most affected by depression and sleep problems during the pandemic. Methods: We conducted a secondary analysis using self-reported data from the 2021 National Health Interview Survey (NHIS), focusing on adults aged 18 years and above (n=29,763). We utilized self-reported responses to questions about prescription medication and frequency of depressive feelings to determine participants' depression status. Appropriate weights were applied to account for the sampling design of the surveys. Our analysis involved descriptive statistics and chi-squared tests to compare sociodemographic, clinical, behavioral, and sleep-related characteristics between US adults with and without depression. Additionally, logistic regression was used to examine the associations between sleep duration, sleep quality and depression. Results: The overall prevalence of depression in our sample was 44.4%. It were higher in certain demographic groups, including younger adults (18-39 years, 47.7%), non-Hispanic whites (47.9%), females (50.1%), those at the lower income bracket (52.2%), those with no college or degree (48.7%) uninsured individuals (45.2%), and those reporting poor general health (71.9%). Individuals with depression had a 12% increased odds of experiencing short sleep (aOR: 1.12, 95% CI:1.04-1.20, p<0.001), 34% increased odds of experiencing long sleep (aOR: 1.34, 95% CI: 1.20-1.50, p < 0.001) and more than 2.5 fold increased odds of reporting poor sleep quality (aOR:2.57, 95% CI: 2.40-2.78; p<0.0001). In the multivariate analysis, all variables (sex, race/ethnicity, education, health insurance coverage, marital status, general health status and use of sleep medications, smoking and alcohol use status) were significantly predictors of poor sleep quality, with the exceptions of age and family income. Conclusion: The findings emphasize the need to address sleep health in treating depression, especially during times of public health crises.

The prognostic role of cigarette smoking in Kidney Cancer Survival.

BACKGROUND: The role of cigarette smoking as a prognostic factor for kidney cancer (KC) is unclear. In this population-based study, we analyze cancer-specific survival (CSS) outcomes among KC patients by smoking status at diagnosis in the diverse state of Florida. METHODS: All primary KC cases from the Florida Cancer Registry diagnosed during 2005-2018 were analyzed. Cox proportional regression was conducted to assess the determinants of KC survival, including age, sex, race/ethnicity, socioeconomic status, histology type, cancer stage, and treatment received with a particular focus on smoking status (smokers at diagnosis referred to as current smokers, former smokers, and never smokers). RESULTS: Among all 36,150 KC patients, 18.3% were smokers at diagnosis (n = 6629), 32.9% were former smokers (n = 11,870), and 48.8% were never smokers (n = 17,651). Age-standardized five-year survival for current, former, and never smokers was 65.3 (95% CI: 64.1-66.5), 70.6 (95% CI: 69.7-71.5), and 75.3 (95% CI: 74.6-76.0) respectively. In multivariable analysis, current and former smokers had an estimated 30% and 14% higher risk of KC death compared to never smokers, respectively, after adjusting for potential confounders (HR: 1.30, 95% CI: 1.23-1.40; HR: 1.14, 95% CI: 1.10-1.20). CONCLUSION: Smoking independently contributes to poorer survival, across all KC stages. Clinicians should encourage and facilitate participation in cigarette smoking cessation programs targeted at current smokers. Prospective studies are warranted to assess the role of different types of tobacco use and cessation programs on KC survival.