We have shown in rats that acute exposure to mainstream smoke or secondhand smoke from marijuana impairs vascular endothelial function, and it has been reported by others that human tobacco smokers and people exposed frequently to secondhand smoke exhibit chronic endothelial dysfunction.  We therefore plan to recruit groups of people who are regular tobacco or marijuana smokers, or marijuana leaf vaporizer users, or people exposed frequently to marijuana secondhand smoke, to determine if they exhibit impaired endothelial function on multiple levels.

1.  Changes in heart rhythms associated with acute cannabis consumption using wearable ECG monitors and concomitant Bluetooth-enabled vaping devices
2. Relationships between healthcare coding for cannabis abuse and cardiovascular outcomes (heart failure, myocardial infarction, atrial fibrillation, ventricular tachycardia, and sudden death) using OSPHD and HCUP databases

We have four active evidence base review projects examining the health effects of marijuana including the effects of marijuana use on cardiovascular risk factors and outcomes, the hemodynamic effects of marijuana use, the pulmonary effects of marijuana use, and the association of marijuana use with cancer. Thus far we have determined that cannabis use is associated with tachycardia and that suggests smoking marijuana is associated with respiratory symptoms including cough and sputum production.

We are pursuing both qualitative and qualitative behavioral studies of tobacco and cannabis co-use.

Smoking and vaping in the outdoors are considered to be normal and acceptable in California and the Pacific Rim region. However, tobacco use in the outdoors results in harmful levels of secondhand smoke exposure, toxic tobacco, vaping and cannabis product waste, and fire hazards. This study identifies factors driving the cultural norm and pervasive notion that it is socially acceptable for smokers to smoke in the outdoors by analyzing past and current tobacco industry advertising, social media and political strategies in California, Thailand and Japan.

My lab studies the chemistry and toxicity of smoke, with a focus on tobacco and cannabis smoke. As part of the UCSF Human Exposure Laboratory, we perform controlled exposure studies that test the immediate health effects of cigarette smoke exposure in human beings.  We have shown that breathing secondhand cigarette smoke causes rapid increases in cardiovascular disease risk and in nasal congestion.  Our research on the chemistry and toxicity of cigarette smoke has helped define a new health risk from smoking: thirdhand cigarette smoke.

We studied whether synthetic CBD (from Insys) could control brain tumors in a mouse model; results were unclear and Insys was not able to provide further support for more studies.  At present, we also are studying how our patient population uses CBD and THC and why and whether it may impact survival. This project is  entitled Impact of Cannabis and Synthetic Cannabinoid Use on Quality of Life in Patients with Central Nervous System Tumors (ICANCNS-QOL)

This project follows a group of patients throughout the US that we surveyed in 2017 to examine how changes recreational legalization in California and other states have effected use of marijuana as well as perceptions of its risks. There is concern that recreational legalization of marijuana could lead to increases in use of tobacco, particularly with the availability of devices that can be used for both substances and the normalization of smoking and vaping.

We have a pilot grant to determine the utility of rat models to study how marijuana use affects cardiac function, and the survival of cardiac tissue after a heart attack.

At the same time that regulations on tobacco and on opioid prescriptions have become more stringent, regulations on cannabis have become less stringent: as of 2019, 11 states had legalized recreational cannabis and an additional 22 states had legalized medical cannabis use. The effects of these diverging trends are not clear, in part due to dramatic differences in local policies. Our work assesses whether localities make consistent choices with respect to substance use policies, and which policies are associated with reduced substance use at the population level.

While co-administration of cannabis and tobacco is becoming increasingly common, the pharmacology of various modalities of co-administration is understudied.

We have benchmarked opinions of a national sample of 16280 US adults on both the risks and benefits of marijuana use in 2017. Overall the public has a favorable impression on the health effects of marijuana and holds beliefs on marijuana that are not currently supported by the evidence. We are continuing this work by examining how the traditional media and social media covers the evidence associated with the potential benefits and harms of cannabis use.

As more states and countries legalize recreational marijuana, the effects of increased marijuana use are impacting tobacco use.  Dr. Glantz studies the implementation of state marijuana policies, whether they are following best practices from tobacco and alcohol control, and how marijuana legalization impacts tobacco.  In collaboration with other UCSF facultym he also studies cardiovascular effects of marijuana smoke.

Several ecologic analyses have demonstrated that rates of opioid related mortality have dropped in states with recreational legalization of cannabis. However, it is unclear how cannabis effects the individual health of opioid users. We have designed a study using national VA data to examine how cannabis use among patients on chronic opioid therapy effects mortality. 

Proposition 64 legalized adult recreational use of cannabis in California, and there are concerns it will lead to an increase in prevalence and intensity of cannabis use in the state. Further, electronic vaporizers, which heat but do not combust cannabis materials, are being introduced in the market for use with cannabis. Vaporizers are perceived as safer alternatives to smoking and are gaining popularity.