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Insights into Oral Inflammation: A Study on Cannabis and Tobacco Products Use

Mayilvanan Chinnalyan
University of Oklahoma

Co-Authors: Daniel Brobst, Geraldine Chissoe, Balaji Sadhasivam, Vengatesh Ganapathy, Lurdes
University of Oklahoma

Introduction: Cannabis and tobacco rank among the most widely used drugs globally. Tobacco use has decreased in the past decade, but use of electronic cigarettes (e-cig) has increased steeply in US among youth and combustible tobacco smokers. The prevalence of cannabis use and co-use with tobacco products has increased steeply. Smoked cannabis is the most common form of use among cannabis users. Combusted cannabis results in a significant buildup of harmful substances in the oral cavity and cannabis use has been shown to increase the progression of oropharyngeal cancer. Some cannabinoids have been identified as anti-inflammatory agents; while others are approved for use in palliative care. However, health implications of smoking cannabis and its co-use with tobacco products use remain uncertain. There is a need to understand the effects of cannabis use and co-use with tobacco and e-cigarettes on oral inflammation.

Aim: To characterize the oral inflammatory patterns among cannabis smokers, tobacco smokers, and e-cig users.

Methods: Upon ethical approval, participants were recruited through a secure online survey platform. Following self-reporting and biochemical confirmation, participants were categorized into four groups: Non-users (NU), exclusive cannabis smokers (CAN), exclusive e-cigarette users
(EC), and combustible tobacco users (TOB). Saliva samples were collected
to evaluate 37 markers of inflammation using an ELISA based assay (Bio-Plex Pro, Bio-Rad). Data was analyzed by ANOVA and independent t-tests.

Results: Data from 45 participants is currently complete: 8 (NU), 11 (CAN), 10 (EC), and 16 (TOB). Compared to non-users, 7 key pro-inflammatory markers were increased in cannabis smokers (e.g., TNFSF-13, GP130,
and IL-6a) and 6 were increased in tobacco smokers (e.g., IFN-g, IL-2, and IL-35). Pro-inflammatory markers also increase in e-cig users, but the increase didn’t reach significance. Compared to non-users there was no significant decrease in inflammatory markers in cannabis, tobacco, or e-cig users. In this relatively small series, the patterns of inflammation varied significantly among the 4 groups. Data for a larger series is currently being analyzed and will be presented.

Conclusion: Our initial findings indicate distinct oral inflammatory patterns among cannabis smokers, combustible tobacco, and e-cig users. Chronic inflammation is recognized as a significant health risk factor, with a critical role in cancer development. Further research is urgent to better elucidate the implications of the varied inflammation patterns observed across different products use.

Grant support: TSET Health Research Promotion Center and NIH/NCI (R01CA242168, Queimado). Dr. Queimado holds a Presbyterian Health Foundation Endowed Chair in Otorhinolaryngology.