The Decibel - The unknown health impacts of cannabis smoke

Episode Date: August 15, 2023

It has been five years since the legalization of cannabis in Canada but we still know very little about health impacts from cannabis smoke. Almost no research has been done, despite government promises, so scientists and experts say we need more data so consumers can make an informed decision.Jameson Berkow is a reporter for the Globe who has covered the cannabis industry extensively. He’s on the show today to explain why this knowledge gap exists and how we can close it.Questions? Comments? Ideas? Email us at [e-mail]

It's been five years since cannabis was legalized in Canada. Yet, we still know very little about the effects of cannabis smoke on our health. That's because there's barely any research into its toxicity, despite what governments have promised. We do know lots about the effects of THC and CBD, which are chemical compounds found in cannabis. But our understanding of the smoke itself is largely based on assumptions about tobacco smoke. Jameson Burko is a financial reporter with The Globe who's covered the cannabis industry extensively. He dug into what we know about the safety of cannabis and what we don't. I'm Cheryl Sutherland,

and this is The Decibel from The Globe and Mail. Jameson, thanks so much for being here today. It's my pleasure. Thanks for having me. Okay, let's start by defining what we're talking about here. How much do we know about the damage caused by smoking cannabis versus consuming it, like a gummy or a drink, for example? Well, we know a lot, actually, about the damage caused or impacts, I should say, caused by cannabis when it's just consumed without combustion, which is to say, without smoking or vaping it, because so much of the research and the warnings and the concern,

frankly, in the lead up to legalization was what the cannabinoids, the THC and CBD, and there's actually hundreds of others, but those are the two big ones, all do to your body. And that's more of like a psychological mental health kind of a question. Absolutely important. But that's where I would say 99% plus of the research really, you know, because every journalist is hesitant to say 100% of anything. Right. of the research really, you know, because every journalist is hesitant to say 100% of anything, right? But absolutely, the lion's share has been on that area. And the actual, you would think more easily and readily available analysis of just, you know, this is a physical act you're doing, this is something that affects your physical body, the cells that make up you as a living organism. And we really have no idea what it actually does.

We can assume, but that's not really all that great when you're talking about science and millions of Canadians and all of the impacts of, you know, what this is now, you know, a legal product. OK, so we're talking here about cannabis smoke, right? Inhaling cannabis. So what data do we actually have on that part of it? Do we know anything about the harms there? There was one study, and I stress one study that was done.

It was done in 2007 based on tests that occurred in 2005 that was testing product that was harvested by Prairie Plant Systems, which for a long time was the only legal producer of cannabis in this country and really globally in 2004. That data actually found that there was much more of, you know, the typical harmful chemicals like hydrocarbons or arsenic or ammonia, all the stuff that we know is in tobacco smoke, but in multiples higher levels. So, you know, people often use the argument, right? That, you know, I might smoke one joint at night,

but a tobacco smoker is going to smoke 15 to 20 cigarettes a day. And so, you know, I'm getting one twentieth of the harm. But let's say like ammonia, for example, there's 20 times as much ammonia in a joint as there is in a cigarette. So you're actually getting about the same amount of ammonia if you smoke that one joint versus 20 cigarettes. So and remember, that is two decade old data. I want to talk about the public perception about cannabis smoking, because anecdotally, I hear people say that cannabis smoking is better than tobacco smoke. But do

we have any information on that? Like, what do we know about what people think about it? We actually have polling data that confirms your view, which is that most people do not consider cannabis to be as harmful. Health Canada does this survey every year, specifically of cannabis consumers. 95% of respondents said that tobacco is at least moderately harmful when smoking. So 95, you can call that pretty much everybody. Only 50% said the same thing about cannabis, which is astounding. And people get really, really emotional and heated whenever anybody raises the possibility that cannabis is in any way harmful. Even if the obvious case of, you know, you're lighting dried plant matter on fire and inhaling the smoke into your body, there's no way that that is, you know, quote unquote, good for you. It's just a question of how bad.

But if you say it's bad at all, you get yourself into a pretty heated argument. Where does this perception come from that cannabis smoke might not be as harmful as tobacco smoke? It's about cherry picking, I think, you know, like they'll cherry pick. There's, in fact, only one study I can think of, although the people on the other side of this argument would probably be able to dredge up maybe a handful that show things like the incidence of lung cancer, say, among even heavy cannabis consumers is the same as non-cannabis consumers. And even if there's, you know, a hundred studies that refute every one

study that shows that people really cling to that results. And they'll say things like, you know, the fact that there's cannabinoids in it will heal the lungs and make it so that, yeah, the smoke is damaging the lungs, but then the cannabinoids get in there and they do their magic endocannabinoid system thing that they do. And it's like, yeah, you know, that doesn't sound like something I'd read in a medical textbook, but you're entitled to your beliefs. So you talked about a couple of studies there. Have they been discredited or are they still accurate? It's difficult to discredit them because they're frankly not really credited in the first place,

like you can't get them peer reviewed. And that's an important point to stress, right? Like when people ask me, you know, did you look outside of Canada to see if maybe globally there had been some research done? And, you know, you have to recall that we're actually the only developed country in the world that allows that kind of research to happen at the federal level. People will point to all the U.S. states that have legalized it, right? But the kind of thing that requires testing to be done, that's federally regulated in the US. So if you're a scientist in the US, you want to do this kind of research. It's technically possible, but it is prohibitively difficult. Okay, so in Canada, we've had legal cannabis for five years. And at the time, governments

promised to fund studies in order to understand the harms. What happened to that? It seems to have just become this political hot potato where all these people, these, and it's important to note, like these are not prohibitionists by any measure. These are some of the ardent supporters of legalization, some of the champions, in fact, of legalization. And they're noted experts in their field and neuroscientists and doctors and physicians and that, you know, certainly not get your kids skateboarding off the sidewalks kind of people. And so they've had all these meetings with various levels of

government, federal and provincial. And based on what they have told me and what I've been able to confirm is that they get this same reaction every time. They get, oh, something definitely has to be done about this. But, you know, it's that person over there or that level of government down there or up there that you need to talk to. And then they'll go talk to them and they'll say, oh, no, no, that's the person you want to talk to. And so everyone says something has to happen. They agree. But then nobody actually wants to take responsibility to make it happen. And then, you know, politically, we know the liberals really saw this as one of the few very clear cut victories and delivering on a promise that they did. And in many ways, it is.

Parliament has now passed Bill C-45, which will legalize and strictly regulate access to cannabis. We will soon have a new system in place, one that keeps cannabis out of the hands of our kids and keeps profits away from organized crime. But at the same time, it's done for them, right? Like this file is closed. And the political capital that would be required to reopen it, even if it's just a little, you sort of have to ask yourself, if you put your political hat on is why would they bother expending resources on something that they could easily just sweep under the rug? This is a basic question, but why is it important to study this? It's about informing consumers, really. And I mean, I appreciate the question because I encountered that a lot when people would say, well, you know, why don't we just assume that it is unhealthy? And it's because in an absence of verified scientific analysis, people fill in

the gaps themselves and they'll either fill it in with, you know, their preconceived notions of, oh, you know, I never smoked anything and I know that smoking it is unhealthy and I'll just leave it at that. But then, you know, you still give space to the whole other side of the argument to say, well, you know, there's these magic cannabinoids that are so beneficial to our health. And maybe maybe that's true. But let's find out for sure. OK, so if the government isn't doing this research, does that mean we're expecting the cannabis industry to do it themselves? Like who is supposed to be doing this research if it's not the government? See, that's the really funny thing, because a lot of people say like, oh, you know, the industry makes so much money. It's like, well,

you know, they make a lot of money, but they also and, you know, we could have a whole separate episode about the follies of the literally billions of dollars that were effectively flushed down toilets in the early couple of years of the industry. But I mean, even just for the sake of argument, let's say the industry is flush. Let's say they make just as much money as alcohol and tobacco, which, you know, they're not certainly crying for handouts from anybody right now. Would we ask, you know, a distillery or a big beer producer to fund research on liver damage? You know, we might ask them, we might force them with laws and regulations, but should we expect them to do it voluntarily? I don't think so. I mean, that is just saying, hey, why don't you go against all your promotional activities and all of your, you know, marketing efforts?

And nobody's going to want to do that. We'll be right back. So is any research at all happening right now in Canada when it comes to cannabis smoke? There was a limited study that was done in 2022. Health Canada actually presented it as this whole like, oh, we've updated our data. We have this 2022 data that's all new. And I took it to lapse. I said, is this true?

Is this all, you know, above board? They said, well, yeah, we did it. It's super limited. It was actually a trial of one product in one specific instance, and they only tested for a handful of different things. So, yeah, we do have some new data, but it's hardly enough to draw conclusions. In fact, the only conclusions we can draw is that comparing that data to what was tested in 2005 shows that we've actually seen an increase in the amount of things like ammonia and other toxic chemicals. Which, frankly, didn't strike me as that surprising, considering how much more effort over the last 20 years has gone into maximizing the efficiency of the production process and making a purer, stronger, more potent product. So we've been focusing on the research that there's very scarce research here. But what about testing?

Because in the case of tobacco, there are regulations, there are laws, testing requirements. Does anything exist for cannabis or how does that compare? That's a really good question because there is an international body that's responsible for not just cannabis, but all sorts of different products and it's based in the u.s and they do have a system of standards and processes that are applied to various types of like cannabis production and testing for certain things like pesticides but they don't have one yet for testing emissions and toxicity because no one's asked for it.

Why? Because we haven't asked for it. No one else is really in a position to ask for it, right? Because they can't do the tests in the US. Okay. Technically speaking, Uruguay could do the tests if they wanted, but simple lack of resources is the issue down there.

I don't believe they have accredited labs that can do this kind of testing. They tend to outsource that to countries that don't have a legalized market. So yeah, we don't know really how to do it. Though I have spoken to a number of scientists who say at the bare minimum, we can apply the same testing standards that are codified in the law of the Tobacco Act right now as a starting off point and then refine them as we continue to do more tests. But the fact is, we have to get to step one first, right, which is somebody willing to

front the cost to do the tests. And right now, no one's willing to do that. What are experts asking for in this case in terms to actually get to that point? Like, what do they think is a solution to getting some sort of action on that? They need about a million bucks. Simply put, they need about a million bucks for Labstat to do the research, put out the results. And I mean, it doesn't necessarily have to be the kind of thing where every single gram of pot produced in the country needs to go about this testing. You know, it's not as though every noodle in a mac and cheese box is tested either, right? Like they

don't do that for even the tests that exist for cannabis right now. You know, they don't test the whole crop. They test a selection of it and it's assumed the rest is the same. So that would be the starting off point. You know, get some testing done, particularly for these new products on the market. Maybe people will still buy it. Probably they will. But at least they'll know a little more

clearly what they're actually buying and what it's going to do to them. In terms of the business side, we know that the legal industry is struggling. Big operators like Tilray and Canopy Growth are still not profitable. You know, in terms of like on the storefront area, walking down the street, I see many closures. Like in Ontario, over 200 cannabis stores closed last year. I guess I'm just wondering, would the added cost of testing and regulation make the illicit market more attractive because the products might be cheaper on that side? Oh, from a price perspective, maybe. But I don't see this really factoring into the price of legal cannabis. If anything, it may impact like the packaging, say. Like I know we made a lot of hay say, like I know we're the, you know,

we made a lot of hay out of the fact that we're the first country in the world that has individual warnings on individual cigarettes right now. That just happened, yeah. Even if we go as far as that for cannabis, the cost of that wouldn't be tremendous. And like, you're right to point out price, because I do think that that's the main driver just as it is for most things, right? Like if you can get a better deal on your cannabis in the illicit market, yeah, you're likely to go into the illicit market to buy it. But if price is about the same, I really struggle to see packaging and warnings on the packaging being like, you know, some cannabis consumer saying, oh, you know, I think I'm going to go buy this

cannabis because it has beautiful flowers on it instead of, you know, pictures of a diseased lung. Like, I just I like to have more faith in the rationality of the average consumer than that, I guess. So we've been talking about the harms, but cannabis can also be used as a medicine. It can be used to treat epilepsy, for example, but it's not prescribed that often by doctors. Do you think that having more research might change that? Absolutely. That's one of the main reasons I think that this is a good idea to

do. I mean, more information is always better than less information. I think that that's, you know, an absolute truism of society in general. But for things that can be used as medicines, that's definitely the issue. I mean, when I was covering the cannabis industry in its very early days, I found that understandably doctors were resistant to prescribe things that they didn't know a lot about. That was their main issue is like, well, we don't know what's in it.

We don't know what it does. So the more that we can say it does X, Y, and Z, then yeah, they're going to be able to comfortably prescribe it in situations that they feel it makes sense. And, you know, for those that say it's still harmful, why would doctors prescribe it at all? I would just ask them to Google Oxycontin and see, you know, the results that come up there.

You know, it's all about that cost benefit analysis, right? It's going to help a lot of patients and does, to your point, currently many millions of patients, in fact. But sure, there's harms to it, too, just as there can be for virtually every other thing that you ingest as a human being. I just want to end on something a little bit more broad, because people still drink. There have been new regulations that come out about drinking in Canada. People still smoke tobacco, even though we know very much the harms of it. I just wonder, would having this data on cannabis, would that make a meaningful difference to

consumers' health in the end? I think so. I think just having that awareness, right? I mean, look at all the data we have on tobacco. And I'll go back to that survey that Health Canada does every year. 95% of cannabis consumers saying that this is actually, that we acknowledge the tobacco smoke is at least moderately harmful. So if we can get something similar in terms of consumer awareness, yeah, you're absolutely

right. People will still choose to do it. And they may have lots of perfectly defensible, reasonable reasons for doing so. But if you look at on the margins of people who might not do it, if they have that information, and as the whole basis of taking something out of the illicit world and bringing it into regular civil society. And so if we can do that, it's going to make people overall, I think,

feel a lot better about the choices we made in the past. Jameson, this has been truly eye-opening. Thank you so much for coming on. I very much enjoyed being here. That's it for today. I'm Cheryl Sutherland. Jay Colburn helped produce this episode. Nagi Nia is our summer producer. Our producers are Madeline White and Rachel Levy-McLaughlin. David Crosby edits the show. Adrian Chung is our senior producer, and Angela Pachenza is our executive editor. Thanks for listening, and I'll talk to you tomorrow.