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Bullous disease of the lung and cannabis smoking - insufficient evidence for a causative link

Bullous disease of the lung and cannabis smoking - insufficient evidence for a causative link

    Journal of the Royal Society of Medicine, Volume 99, February 2006

    Carol Tan, N Hatam, Tom Treasure | J R Soc Med 2006;99:77–80


    Cannabis smoking appears on teaching slides as a cause of bullous lung disease and consequent pneumothorax. This seems to have become received wisdom—‘A striking feature of cannabis smoking is that it is associated with bullous lung disease in young people’. 1 The authors cite a report of four cases. 2 The suggestion appears, albeit in more muted terms, with the same citation in a UK Parliamentary memorandum on adverse effects of smoking marijuana on lung health. 3

    What is the evidence that cannabis smoking causes bullous lung disease and what is its association, directly or indirectly, with pneumothorax?


    The Research Committee of the British Thoracic Society was asked in June 2004 to investigate the supposed association between cannabis smoking and pneumothorax associated with giant lung bullae. We undertook the task. We agreed that there was insufficient evidence to justify setting up any larger study so these findings are as far as we took the question. We were encouraged by the Chair and Committee to publish our conclusions but the views expressed are those of the authors.