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Holy Smokes: The Health Effects of the Substances We Inhale

By Dr. Kohar Jones

"What do you think of medical marijuana?" my mother, who has never smoked a thing in her life, of the tobacco or cannabis variety, asked me one day as we drove through beautiful upstate New York woods.  We had just passed a sign saying "We will destroy your crops," with a marijuana leaf beneath. "It has its place," I said.  "No reason to be against it." "But isn't marijuana a terrible substance?" she asked. "No worse than tobacco or alcohol," I told her my honest opinion.

When I started on the wards and saw how many people who smoked or drank were really sick from it--advanced cancer, emphysema, advanced liver disease--I was shocked these substances were legal.  Take nicotine--the most addictive substance, harder to quit than heroin or cocaine.  It's just that tobacco has a historical monopoly on legal inhalation.

"So why is marijuana illegal?" she asked. "Historical accident," I said. As a senior in college, I took a history class called "Drugs and Alcohol in American Culture." I wrote my term paper on shifting medical perceptions of marijuana, from the thirties to the seventies. I was intrigued by the association between social perceptions and scientific conclusions.

There was one scientist in particular whose conclusions about the effects of marijuana radically shifted as cultural perceptions shifted from the 1930s to the 1970s.  In the 1930s, he offered scientific evidence to reflect the social understanding of marijuana as a substance that provoked crazed violent reactions, when the drug was associated with Mexican immigrants and crime.  In the 1970s, his research showed marijuana provoked a slackadaisical laziness with loss of motivation when it was used by the nation's youth.  No crime, no trouble.

"It was almost legalized," I added, "until Nixon squashed that idea." "Why are they legalizing it now?" she asked. "They probably need the tax money.  If you turn it into a legitimate business, you get to collect legitimate taxes."

Newsweek addressed the issue a week later in an interesting sidebar by R. M Schneiderman, entitled "legal weed gets a reality check in California." Advocates of legalized marijuana say it will increase state tax revenue, and also undercut Mexican drug cartels.   He argues that taxing locally grown marijuana will price it out of the street market, leaving the market wide open for Mexican-grown marijuana, and no real change in the dangerous Mexican criminal activity that marijuana use bolsters.

Suddenly, we're back in the 1930s again, with marijuana associated with crazed Mexican criminal activity.

I don't use marijuana.  I don't prescribe it.  Nor do I smoke tobacco, or advise patients to smoke it.  One is illegal.  One is legal. In suburban Cook County, there are an estimated 391,273 tobacco smokers. In Illinois in 2008, smoking caused an estimated health cost of $4.1 billion. Legal tobacco and illegal marijuana are historical accidents that cost America billions of dollars.

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