Smoke is Smoke Secondhand Marijuana Smoke Cynthia Hallett, MPH President and CEO National Council of Legislators from Gaming States June 2017

Source: National Conference of State Legislatures http://www.ncsl.org/bookstore/state-legislatures-magazine/marijuana-deep-dive.aspx 59.3% of US population now lives in a state where marijuana is legalized. 29 states plus DC, Guam, and Puerto Rico have medical MJ legalized; 19 states plus DC have operating dispensaries; 8 have recreational MJ legalized. Seven states and the District of Columbia have adopted more expansive laws legalizing marijuana for recreational use. Most recently, California, Massachusetts, Maine and Nevada all passed measures in November legalizing recreational marijuana. California’s Prop. 64 measure allows adults 21 and older to possess up to one ounce of marijuana and grow up to six plants in their homes. Other tax and licensing provisions of the law will not take effect until January 2018. Several legislatures in states recently passing legalization measures are debating regulatory proposals around the use and sale of marijuana. Massachusetts lawmakers are weighing bills that would lower the amount that residents can legally possess or place restrictions on retails stores. In Nevada, one proposal calls for businesses to obtain permits allowing for the public use of marijuana. A number of states have also decriminalized the possession of small amounts of marijuana. Other states have passed medical marijuana laws allowing for limited use of cannabis. Some medical marijuana laws are broader than others, with types of medical conditions that allow for treatment varying from state to state. Others states (not shown on the map below) have passed laws allowing residents to possess cannabis oil if they suffer from certain medical illnesses. Source: National Conference of State Legislatures

Ventilation is NOT a solution to secondhand smoke or secondhand aerosol “At a minimum, establish and maintain smoke-free workplaces that protect those in workplaces from secondhand exposures to tobacco smoke and airborne emissions from e-cigarettes and other electronic nicotine delivery systems. Smoke-free zones should encompass (1) all indoor areas without exceptions (i.e., no indoor smoking areas of any kind, even if separately enclosed and/or ventilated), (2) all areas immediately outside building entrances and air intakes, and (3) all work vehicles. Additionally, ashtrays should be removed from these areas.”

Similarities between tobacco and marijuana Leaf contains high concentrations of oils and waxes “sticky icky” Nicotine and THC both survive combustion Combustion creates carcinogens Polycyclic aromatic hydrocarbons Formaldehyde Nitrogen oxides Heavy metals Ultrafine particles Suzaynn F. Schick, PhD University of California, San Francisco Carcinogens cause cellular destruction which leads to cancer.

Secondhand Marijuana Smoke Secondhand marijuana smoke contains hundreds of chemicals. Many of the chemicals in secondhand marijuana smoke are toxic and contain hazardous fine particles that pose a significant health risk to non-smokers. Regarding marijuana users: there is an increased stroke and heart failure with mj use: 20 million health records of patients aged 18 to 55  After adjusting for those risk factors, the researchers concluded that marijuana use was independently associated with a 26 percent increased risk of stroke and a 10 percent increased risk of heart failure.

Health Effects of Secondhand Exposure Secondhand marijuana smoke exposure impairs blood vessel function. It has a greater and longer-lasting effect on blood vessel function than exposure to secondhand tobacco smoke. People who are exposed to secondhand marijuana smoke can have detectable levels of THC in their blood and urine. Molecule of tetra-hydro-can-na-binol, or THC, the main mind-altering ingredient found in the Cannabis plant. Long-term exposure of the workforce to the active ingredients in these smoked products could lead to health complications.

Electronic Smoking Devices THC oils and dry herbs are being inhaled via electronic smoking devices (and exhaled into the environment). “E-cigarettes for marijuana are already widely available, but the mCig is different. It's something of a hybrid between an e-cig and a joint, in that you can put "dry herb" in it and heat it to the edge of combustion.” E-joint Haze Dual for leaf and oils or waxes

Cumulative Number of Laws Regulating Marijuana Smoking As of May 25, 2017, there are 290 local laws specifically restricting marijuana use in some or all smokefree spaces 2013 and prior: 91 2014: 52 new for 143 local laws 2015: 72 new for 215 local laws 2016: 59 new for 274 local laws 2017 to date (5/25) new for 16: 290 total local laws www.no-smoke.org

Conclusions and Recommendations Marijuana, legal or not, creates secondhand smoke. There is science about the particulate matter created by secondhand marijuana smoke, and more is coming. There is science about the health effects of secondhand marijuana smoke, and more is coming. If we truly want to have safe, healthy, smokefree spaces, then they should be devoid of particulate matter created by tobacco cigarette smoke, marijuana smoke, and secondhand aerosol from electronic smoking devices. Research demonstrates that ventilation systems cannot remove all of the hazardous gases, toxins, and particulate matter created by secondhand smoke and aerosol; therefore, ventilation is not a solution. Smokefree environments protect workers and patrons from exposure to secondhand smoke and aerosol.

Cynthia Hallett, MPH Cynthia.Hallett@no-smoke.org anr@no-smoke.org 510-841-3032