Heavy cannabis smokers have lesser bone density than cigarette smokers and are prone to more fractures. That’s according to a new analysis of 170 regular cannabis smokers and 114 controls who only smoke cigarettes.

Researchers from the University of Edinburgh (Scotland) measured bone density among participants using a specialized x-ray technique: DEXA scan. They found that bone density of heavy cannabis smokers was about 5% lower than the control group of cigarette smokers who did not smoke cannabis. Heavy cannabis use was defined in the study as smoking cannabis ≥5,000 times in their lifetime. 

Results showed that heavy cannabis users had lower total hip bone mineral density (mean ± SD Z-score: –0.20 ± 0.9 vs. ± 0.2 ± 0.9, P<.0005), lower spine bone mineral density (–0.5 ± 1.2 vs. 0.0 ± 1.2, P<.0005), and lower body mass index (BMI; 26.5 ± 6.0 vs. 29.0 ± 7.0, P=.01) than controls. Fracture rate was also increased in heavy users (rate ratio = 2.17; 95% CI, 1.59-2.95; P<.001). 

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The researchers speculate that lowering BMI among heavy users is due to cannabis’ effect of reducing appetite when taken in large amounts over a long period of time. “Our research has shown that heavy users of cannabis have quite a large reduction in bone density compared with non-users and there is a real concern that this may put them at increased risk of developing osteoporosis and fractures later in life,” said lead author and professor at the University of Edinburgh, Stuart Ralston. 

This study is the first to examine bone density and its associations with cannabis use. The authors call for more research to be conducted in this area to shed more light on cannabis use and subsequent bone health implications.

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