<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-0390</journal-id>
<journal-title><![CDATA[Revista Médica del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Méd. Urug.]]></abbrev-journal-title>
<issn>1688-0390</issn>
<publisher>
<publisher-name><![CDATA[Sindicato Médico del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-03902025000101204</article-id>
<article-id pub-id-type="doi">10.29193/rmu.41.1.5</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Efectos del cannabis inhalado en la salud respiratoria: estudio observacional]]></article-title>
<article-title xml:lang="en"><![CDATA[Effects of inhaled cannabis on respiratory health: observational study]]></article-title>
<article-title xml:lang="pt"><![CDATA[Efeitos do cannabis inalado na saúde respiratória: estudo observacional]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Caggiani]]></surname>
<given-names><![CDATA[Lucía Fernández]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Soto]]></surname>
<given-names><![CDATA[Juan Pablo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alemán]]></surname>
<given-names><![CDATA[Alicia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Torres]]></surname>
<given-names><![CDATA[Ignacio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Romero]]></surname>
<given-names><![CDATA[Luciana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Liencres]]></surname>
<given-names><![CDATA[Agustina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alonso]]></surname>
<given-names><![CDATA[Rafael]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Torres]]></surname>
<given-names><![CDATA[Verónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gutiérrez]]></surname>
<given-names><![CDATA[Martha]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la República Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de la República Facultad de Química ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<volume>41</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-03902025000101204&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-03902025000101204&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-03902025000101204&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: El cannabis es la droga ilícita más consumida a nivel mundial y la segunda sustancia más fumada luego del tabaco. En los últimos años numerosos estudios han intentado valorar su impacto en la salud respiratoria con resultados discordantes.  Objetivo: Estudiar el efecto del cannabis inhalado en síntomas respiratorios y función pulmonar en comparación con el tabaco y con no fumadores.  Métodos: Se incluyeron adultos provenientes de clubes cannábicos e instituciones públicas de nuestro país. Se realizaron cuestionarios sobre características sociodemográficas, síntomas respiratorios y hábitos de consumo. Se complementó con estudio funcional respiratorio. Se dividieron en 4 grupos: grupo cannabis (C), grupo tabaco (T), grupo cannabis-tabaco (C-T) y grupo no fumadores (NF).  Resultados: Se estudiaron 375 individuos: grupo cannabis (63), tabaco (117), cannabis-tabaco (50), no fumadores (145). El grupo cannabis, cannabis-tabaco, y tabaco, presentaron mayor prevalencia de al menos un síntoma respiratorio crónico (sibilancias, la tos y la expectoración) comparado con el grupo no fumador (p&lt;0,001). La capacidad vital forzada fue significativamente mayor en los grupos consumidores de cannabis (C, C-T). No se hallaron otras alteraciones significativas en la espirometría.  Conclusiones: Fumar cannabis se asocia con síntomas respiratorios crónicos. Si bien no se han detectado cambios clínicamente relevantes en la función pulmonar, se requieren más estudios a largo plazo. Interrogar sobre el consumo de cannabis debería incorporarse en la práctica clínica, educando sobre los potenciales riesgos en salud.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Cannabis is the most widely used illicit drug worldwide and the second most smoked substance after tobacco. In recent years, numerous studies have attempted to assess its impact on respiratory health with conflicting results.  Objective: To study the effect of inhaled cannabis on respiratory symptoms and lung function compared to tobacco and non-smokers.  Methods: Adults from cannabis clubs and public institutions in our country were included. Questionnaires on sociodemographic characteristics, respiratory symptoms, and consumption habits were conducted. This was complemented with pulmonary function testing. Participants were divided into 4 groups: cannabis group (C), tobacco group (T), cannabis-tobacco group (C-T), and non-smokers group (NS).  Results: A total of 375 individuals were studied: cannabis group (63), tobacco (117), cannabis-tobacco (50), and non-smokers (145). The cannabis, cannabis-tobacco, and tobacco groups showed a higher prevalence of at least one chronic respiratory symptom (wheezing, cough, and sputum) compared to the non-smokers group (p&lt;0.001). Forced vital capacity was significantly higher in cannabis users (C, C-T). No other significant spirometry alterations were found.  Conclusions: Smoking cannabis is associated with chronic respiratory symptoms. Although no clinically relevant changes in lung function were detected, further long-term studies are required. Inquiry about cannabis use should be incorporated into clinical practice, with education on potential health risks.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução: A cannabis é a droga ilícita mais consumida no mundo e a segunda substância mais fumada depois do tabaco. Nos últimos anos, numerosos estudos tentaram avaliar o seu impacto na saúde respiratória, com resultados conflitantes.  Objetivo: Estudar o efeito da cannabis inalada nos sintomas respiratórios e na função pulmonar em comparação com o tabaco e não fumantes.  Métodos: Foram incluídos adultos provenientes de clubes de cannabis e instituições públicas do nosso país. Foram aplicados questionários sobre características sociodemográficas, sintomas respiratórios e hábitos de consumo. Complementou-se com estudo funcional respiratório. Os participantes foram divididos em 4 grupos: grupo cannabis (C), grupo tabaco (T), grupo cannabis-tabaco (C-T) e grupo não fumantes (NF).  Resultados: Foram estudados 375 indivíduos: grupo cannabis (63), tabaco (117), cannabis-tabaco (50) e não fumantes (145). Os grupos cannabis, cannabis-tabaco e tabaco apresentaram maior prevalência de pelo menos um sintoma respiratório crônico (sibilos, tosse e expectoração) em comparação com o grupo não fumantes (p&lt;0,001). A capacidade vital forçada foi significativamente maior nos grupos consumidores de cannabis (C, C-T). Não foram encontradas outras alterações significativas na espirometria.  Conclusões: Fumar cannabis está associado a sintomas respiratórios crônicos. Embora não tenham sido detectadas alterações clinicamente relevantes na função pulmonar, são necessários mais estudos de longo prazo. Questionar sobre o consumo de cannabis deve ser incorporado à prática clínica, com educação sobre os potenciais riscos à saúde.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Cannabis]]></kwd>
<kwd lng="es"><![CDATA[Marihuana]]></kwd>
<kwd lng="es"><![CDATA[Síntomas respiratorios]]></kwd>
<kwd lng="es"><![CDATA[Función pumonar]]></kwd>
<kwd lng="es"><![CDATA[Tabaco]]></kwd>
<kwd lng="en"><![CDATA[Cannabis]]></kwd>
<kwd lng="en"><![CDATA[Marijuana]]></kwd>
<kwd lng="en"><![CDATA[Respiratory symptoms]]></kwd>
<kwd lng="en"><![CDATA[Lung function]]></kwd>
<kwd lng="en"><![CDATA[Tobacco]]></kwd>
<kwd lng="pt"><![CDATA[Cannabis]]></kwd>
<kwd lng="pt"><![CDATA[Maconha]]></kwd>
<kwd lng="pt"><![CDATA[Sintomas respiratórios]]></kwd>
<kwd lng="pt"><![CDATA[Função pulmonar]]></kwd>
<kwd lng="pt"><![CDATA[Tabaco]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tan]]></surname>
<given-names><![CDATA[WC]]></given-names>
</name>
<name>
<surname><![CDATA[Lo]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Jong]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Xing]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[FitzGerald]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Vollmer]]></surname>
<given-names><![CDATA[WM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Marijuana and chronic obstructive lung disease: a population-based study]]></article-title>
<source><![CDATA[Can Med Assoc J]]></source>
<year>2009</year>
<volume>180</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>814-20</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2.</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sendino]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Alvarez]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Brime]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Llorens]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Ruiz]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sanchez]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[OEDA. Informe 2017. Alcohol, tabaco y drogas ilegales en España]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B3">
<label>3.</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Roballo]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Olivera]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Cannizzo]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Torres]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Suarez]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Ramirez]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[VII Encuesta Nacional sobre Consumo de Drogas en Población General: informe de investigación]]></source>
<year>2019</year>
</nlm-citation>
</ref>
<ref id="B4">
<label>4.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Keyhani]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Steigerwald]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ishida]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Vali]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Cerdá]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hasin]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risks and benefits of marijuana use: a national survey of U.S. adults]]></article-title>
<source><![CDATA[Ann Intern Med]]></source>
<year>2018</year>
<volume>169</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>282-90</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Azofeifa]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mattson]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Schauer]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[McAfee]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Grant]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Lyerla]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[National estimates of marijuana use and related indicators: National Survey on Drug Use and Health, United States, 2002-2014]]></article-title>
<source><![CDATA[MMWR Surveill Summ]]></source>
<year>2016</year>
<volume>65</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1-28</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hoffmann]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Brunnemann]]></surname>
<given-names><![CDATA[KD]]></given-names>
</name>
<name>
<surname><![CDATA[Gori]]></surname>
<given-names><![CDATA[GB]]></given-names>
</name>
<name>
<surname><![CDATA[Wynder]]></surname>
<given-names><![CDATA[EL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[On the carcinogenicity of marijuana smoke]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Runeckles]]></surname>
<given-names><![CDATA[VC]]></given-names>
</name>
</person-group>
<source><![CDATA[Recent advances in phytochemistry]]></source>
<year>1975</year>
<page-range>63-73</page-range><publisher-loc><![CDATA[Boston ]]></publisher-loc>
<publisher-name><![CDATA[Springer]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Novotny]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Merli]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Weisler]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Fenci]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Saeed]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fractionation and capillary gas chromatographic mass spectrometric characterization of neutral components in marijuana and tobacco smoke concentrates]]></article-title>
<source><![CDATA[J Chromatogr A]]></source>
<year>1982</year>
<volume>238</volume>
<page-range>141-50</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Meier]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Vandrey]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Rubin]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Pacek]]></surname>
<given-names><![CDATA[LR]]></given-names>
</name>
<name>
<surname><![CDATA[Jensen]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Donny]]></surname>
<given-names><![CDATA[EC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cigarette smokers versus cousers of cannabis and cigarettes: exposure to toxicants]]></article-title>
<source><![CDATA[Nicotine Tob Res]]></source>
<year>2020</year>
<volume>22</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>1383-9</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tashkin]]></surname>
<given-names><![CDATA[DP]]></given-names>
</name>
<name>
<surname><![CDATA[Baldwin]]></surname>
<given-names><![CDATA[GC]]></given-names>
</name>
<name>
<surname><![CDATA[Sarafian]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Dubinett]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Roth]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Respiratory and immunologic consequences of marijuana smoking]]></article-title>
<source><![CDATA[J Clin Pharmacol]]></source>
<year>2002</year>
<volume>42</volume>
<numero>S1</numero>
<issue>S1</issue>
<page-range>71S-81S</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ghasemiesfe]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ravi]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Vali]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Korenstein]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Arjomandi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Frank]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Marijuana use, respiratory symptoms, and pulmonary function: a systematic review and meta-analysis]]></article-title>
<source><![CDATA[Ann Intern Med]]></source>
<year>2018</year>
<volume>169</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>106-15</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[TC]]></given-names>
</name>
<name>
<surname><![CDATA[Tashkin]]></surname>
<given-names><![CDATA[DP]]></given-names>
</name>
<name>
<surname><![CDATA[Djahed]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Rose]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pulmonary hazards of smoking marijuana as compared with tobacco]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>1988</year>
<volume>318</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>347-51</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Howden]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Naughton]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pulmonary effects of marijuana inhalation]]></article-title>
<source><![CDATA[Expert Rev Respir Med]]></source>
<year>2011</year>
<volume>5</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>87-92</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moore]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
<name>
<surname><![CDATA[Augustson]]></surname>
<given-names><![CDATA[EM]]></given-names>
</name>
<name>
<surname><![CDATA[Moser]]></surname>
<given-names><![CDATA[RP]]></given-names>
</name>
<name>
<surname><![CDATA[Budney]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Respiratory effects of marijuana and tobacco use in a U.S. sample]]></article-title>
<source><![CDATA[J Gen Intern Med]]></source>
<year>2005</year>
<volume>20</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>33-7</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
<name>
<surname><![CDATA[Hancox]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effects of smoking cannabis on lung function]]></article-title>
<source><![CDATA[Expert Rev Respir Med]]></source>
<year>2011</year>
<volume>5</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>537-46</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tashkin]]></surname>
<given-names><![CDATA[DP]]></given-names>
</name>
<name>
<surname><![CDATA[Coulson]]></surname>
<given-names><![CDATA[AH]]></given-names>
</name>
<name>
<surname><![CDATA[Clark]]></surname>
<given-names><![CDATA[VA]]></given-names>
</name>
<name>
<surname><![CDATA[Simmons]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bourque]]></surname>
<given-names><![CDATA[LB]]></given-names>
</name>
<name>
<surname><![CDATA[Duann]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Respiratory symptoms and lung function in habitual heavy smokers of marijuana alone, smokers of marijuana and tobacco, smokers of tobacco alone, and nonsmokers]]></article-title>
<source><![CDATA[Am Rev Respir Dis]]></source>
<year>1987</year>
<volume>135</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>209-16</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16.</label><nlm-citation citation-type="">
<collab>IMPO</collab>
<source><![CDATA[Uruguay. Ley 19.172: marihuana y sus derivados: control y regulación del estado de la importación, producción, adquisición, almacenamiento, comercialización y distribución]]></source>
<year>2013</year>
<publisher-loc><![CDATA[Uruguay ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B17">
<label>17.</label><nlm-citation citation-type="">
<source><![CDATA[Instituto de Regulación y Control del Cannabis (IRCCA)]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B18">
<label>18.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Graham]]></surname>
<given-names><![CDATA[BL]]></given-names>
</name>
<name>
<surname><![CDATA[Steenbruggen]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Miller]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Barjaktarevic]]></surname>
<given-names><![CDATA[IZ]]></given-names>
</name>
<name>
<surname><![CDATA[Cooper]]></surname>
<given-names><![CDATA[BG]]></given-names>
</name>
<name>
<surname><![CDATA[Hall]]></surname>
<given-names><![CDATA[GL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Standardization of spirometry 2019 update: an official American Thoracic Society and European Respiratory Society technical statement]]></article-title>
<source><![CDATA[Am J Respir Crit Care Med]]></source>
<year>2019</year>
<volume>200</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>e70-88</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[von Elm]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Altman]]></surname>
<given-names><![CDATA[DG]]></given-names>
</name>
<name>
<surname><![CDATA[Egger]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Pocock]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Gøtzsche]]></surname>
<given-names><![CDATA[PC]]></given-names>
</name>
<name>
<surname><![CDATA[Vandenbroucke]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
</person-group>
<collab>STROBE Initiative</collab>
<article-title xml:lang=""><![CDATA[Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies]]></article-title>
<source><![CDATA[BMJ]]></source>
<year>2007</year>
<volume>335</volume>
<numero>7624</numero>
<issue>7624</issue>
<page-range>806-8</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kaplan]]></surname>
<given-names><![CDATA[AG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cannabis and lung health: does the bad outweigh the good?]]></article-title>
<source><![CDATA[Pulm Ther]]></source>
<year>2021</year>
<volume>7</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>395-408</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Owen]]></surname>
<given-names><![CDATA[KP]]></given-names>
</name>
<name>
<surname><![CDATA[Sutter]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Albertson]]></surname>
<given-names><![CDATA[TE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Marijuana: respiratory tract effects]]></article-title>
<source><![CDATA[Clin Rev Allergy Immunol]]></source>
<year>2014</year>
<volume>46</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>65-81</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Polen]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Sidney]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Tekawa]]></surname>
<given-names><![CDATA[IS]]></given-names>
</name>
<name>
<surname><![CDATA[Sadler]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Friedman]]></surname>
<given-names><![CDATA[GD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Health care use by frequent marijuana smokers who do not smoke tobacco]]></article-title>
<source><![CDATA[West J Med]]></source>
<year>1993</year>
<volume>158</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>596-601</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Winhusen]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Theobald]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Kaelber]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
<name>
<surname><![CDATA[Lewis]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Regular cannabis use, with and without tobacco co-use, is associated with respiratory disease]]></article-title>
<source><![CDATA[Drug Alcohol Depend]]></source>
<year>2019</year>
<volume>204</volume>
<page-range>107557</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pletcher]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Vittinghoff]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Kalhan]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Richman]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Safford]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Sidney]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association between marijuana exposure and pulmonary function over 20 years]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>2012</year>
<volume>307</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>173-81</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kempker]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Honig]]></surname>
<given-names><![CDATA[EG]]></given-names>
</name>
<name>
<surname><![CDATA[Martin]]></surname>
<given-names><![CDATA[GS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The effects of marijuana exposure on expiratory airflow]]></article-title>
<source><![CDATA[Ann Am Thorac Soc]]></source>
<year>2015</year>
<volume>12</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>135-41</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Morris]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Jacobson]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
<name>
<surname><![CDATA[Kinney]]></surname>
<given-names><![CDATA[GL]]></given-names>
</name>
<name>
<surname><![CDATA[Tashkin]]></surname>
<given-names><![CDATA[DP]]></given-names>
</name>
<name>
<surname><![CDATA[Woodruff]]></surname>
<given-names><![CDATA[PG]]></given-names>
</name>
<name>
<surname><![CDATA[Hoffman]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Marijuana use associations with pulmonary symptoms and function in tobacco smokers enrolled in the Subpopulations and Intermediate Outcome Measures in COPD study (SPIROMICS)]]></article-title>
<source><![CDATA[Chronic Obstr Pulm Dis]]></source>
<year>2018</year>
<volume>5</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>46-56</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hancox]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Poulton]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Ely]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Welch]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Taylor]]></surname>
<given-names><![CDATA[DR]]></given-names>
</name>
<name>
<surname><![CDATA[McLachlan]]></surname>
<given-names><![CDATA[CR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effects of cannabis on lung function: a population-based cohort study]]></article-title>
<source><![CDATA[Eur Respir J]]></source>
<year>2010</year>
<volume>35</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>42-7</page-range></nlm-citation>
</ref>
<ref id="B28">
<label>28.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tetrault]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Crothers]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Moore]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
<name>
<surname><![CDATA[Mehra]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Concato]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Fiellin]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effects of marijuana smoking on pulmonary function and respiratory complications: a systematic review: A systematic review]]></article-title>
<source><![CDATA[Arch Intern Med]]></source>
<year>2007</year>
<volume>167</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>221-8</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Aldington]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Williams]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Nowitz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Weatherall]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Pritchard]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[McNaughton]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effects of cannabis on pulmonary structure, function and symptoms]]></article-title>
<source><![CDATA[Thorax]]></source>
<year>2007</year>
<volume>62</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1058-63</page-range></nlm-citation>
</ref>
<ref id="B30">
<label>30.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tashkin]]></surname>
<given-names><![CDATA[DP]]></given-names>
</name>
<name>
<surname><![CDATA[Simmons]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Sherrill]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
<name>
<surname><![CDATA[Coulson]]></surname>
<given-names><![CDATA[AH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Heavy habitual marijuana smoking does not cause an accelerated decline in FEV1 with age]]></article-title>
<source><![CDATA[Am J Respir Crit Care Med]]></source>
<year>1997</year>
<volume>155</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>141-8</page-range></nlm-citation>
</ref>
<ref id="B31">
<label>31.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hancox]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Gray]]></surname>
<given-names><![CDATA[AR]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Poulton]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Moffitt]]></surname>
<given-names><![CDATA[TE]]></given-names>
</name>
<name>
<surname><![CDATA[Caspi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Differential effects of cannabis and tobacco on lung function in mid-adult life]]></article-title>
<source><![CDATA[Am J Respir Crit Care Med]]></source>
<year>2022</year>
<volume>205</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1179-85</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
