Several of my patients are habitual marijuana smokers and refuse to quit. Can they lower their health risks by smoking from a bong rather than a joint?—MARY CARVER, PA-C, Indian Shores, Fla.

The National Institute on Drug Abuse cites studies that found that marijuana smoke—like tobacco smoke—can harm the lungs and that use of marijuana can distort perception as well as impair short-term memory, verbal skills, and judgment. Whether rolling marijuana into a cigarette (“joint”) or smoking it in a water pipe (“bong”) is more or less risky has not been studied, as far as I can tell. The literature says that a typical joint contains 0.5-1.0 g of cannabis plant matter, which varies in d-9-tetrahydrocannabinol (THC) content between 5 and 150 mg. THC accounts for most of marijuana’s psychoactive or mind-altering effects. The strength of the drug is determined by the amount of THC it contains. One study found that dependence is more frequent in those who use means of consumption other than joints (Arch Pediatr. 2002;9:780-788).—JoAnn Deasy, PA-C, MPH簃(146-2)

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