Marijuana and vaping have a few things in common: both are legal, both can be inhaled, and both are consumed predominantly by young people. As a fertility doctor, I am concerned that the highest users of these products are also in, or nearing, their reproductive prime.
I get questions all the time from prospective parents. They ask, “Is smoking weed safe during pregnancy?” or “Will vaping hurt my sperm?” I usually respond with a semi-potent lecture encouraging them to be cautious, try to avoid it, or at least cut down. I apologize that I do not have better data. “We really need to do more research,” I normally conclude.
My response is so well-honed that I had not paused to consider how “we” are going to fund these studies, which are so desperately needed. Should doctors, scientists, government and taxpayers be responsible for investigating the effects of marijuana and vaping on people’s long-term health and the health of their offspring?
Kevin Burns, the recently replaced CEO of vape giant JUUL, has stated that they test the “toxicology” of their products, but have not done the “long-term longitudinal clinical testing.” Cannabis producers have also failed to take up the task of publishing high-quality data.
Meanwhile, the federal government announced in May 2019 that it would spend $24.5 million to fund cannabis research from the Canadian Institutes of Health Research (CIHR). Support from the CIHR and Health Canada has also been dedicated to researchers, policy-makers and health practitioners to study vaping. Similarly in America, the National Cancer Institute and the National Institute on Drug Abuse have funded two of the largest studies on vaping to date.
If cannabis or vaping products were formulated and tested like pharmaceuticals, they would be subject to four trial phases. The last phase, known as post-market surveillance, refers to when the company must be watching how its drug affects the public. Doctors, scientists and government do take responsibility for reporting adverse events and conducting research on medications, but in the case of pharmaceuticals, “we” are not the only stakeholders.
Right now, it appears that observing a massive outcry and declining shareholder value is the only post-market surveillance that vaping (and maybe marijuana) companies are planning to do. Is it unreasonable for the public to demand that industry fund the necessary research?
Vaping and marijuana producers have profited tremendously from selling these products, yet they rely on the cash-strapped healthcare system to determine if they are harmful. JUUL for example, founded in 2015, was valued at over $40 billion in 2018 when Altria made a minority investment. Canopy Growth, the largest cannabis company in Canada, has a market capitalization of approximately $11 billion, which has increased from $2 billion in two years.
Funding observational trials with their profits would give producers more credibility, which is needed, particularly on the heels of the vaping crisis in North America. It might also be in these companies’ best financial interests — look at the effects of tobacco and the litigation and awards that followed.
The JUUL terms of service agreement states: “If you have any health concerns about use of JUUL or any other product, we recommend that you consult with your physician.”
I am always happy to see my patients and answer their questions. But when it comes to recreational marijuana smoking or vaping, my response to patients should be different. We need JUUL and the other producers to provide us the data so I may properly answer the questions.
Dr. Caitlin Dunne, MD, FRCSC, is a co-director at the Pacific Centre for Reproductive Medicine in Vancouver and a clinical assistant professor at the University of B.C. She serves on the editorial board of the British Columbia Medical Journal and was recently named one of Canada’s Top 40 Under 40.
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