Chronic Cannabis Smoking, Oxidative Stress and the Pulmonary Innate Immune Response

Eligibility Criteria

• 1. Daily or near daily cannabis use (inhaled via joint/cigarette or pipe) equivalent to AT LEAST 20 "joint years" (number of joints/cigarettes per day multiplied by number of years during which cannabis was smoked) by self-report and validated through urine drug screen.
• 2. Never or limited exposure to inhaled tobacco products (equivalent to LESS THAN one "pack year" in a lifetime) by selfreport and validated through negative urine cotinine screen.
• 3. Capacity to answer screening questions and provide informed consent at time of interview, along with contact information
• 1. No cannabis use ever by self-report, and validated through urine drug screen.
• 2. Never users of tobacco/cigarettes
• 3. Capacity to answer screening questions and provide informed consent at time of interview, along with contact information.
• 1. LESS THAN near daily cannabis use (inhaled via joint/cigarette or pipe) equivalent to LESS THAN 20 "joint years" (number of joints/cigarettes per day multiplied by number of years during which cannabis was smoked) or a negative urine drug screen (for cannabis)
• 2. Inhaled tobacco product exposure EXCEEDING one "pack year" or a positive urine cotinine screen
• 3. Elevated AUDIT-C score: A 3 item questionnaire to identify subjects with alcohol use disorders.
• 4. Prior medical history of liver disease: cirrhosis, total bilirubin \> 2.0 mg/dL or albumin \<3
• 5. Prior medical history of myocardial infarction or congestive heart failure
• 6. Prior medical history of end-stage renal disease or serum creatinine \>3 mg/dL
• 7. Prior history of or current use of illicit drug use defined as a positive toxicology screen for opiates or cocaine
• 8. Prior history of diabetes mellitus
• 9. Prior history of chronic obstructive pulmonary disease (COPD) or asthma that is not clinically controlled (have not required systemic corticosteroids in the past month)
• 10. Prior history of HIV, not controlled or on medication
• 11. Peripheral white blood cell count of less than 3000
• 12. Acute worsening (\<7 days) in respiratory symptoms (such as change in cough frequency or sputum production, fever, dyspnea, abnormal chest radiograph), or room air pulse oximetry of \< 92% at rest or spirometry of \< 50% predicted for FEV1 and FVC
• 13. Use of systemic antibiotics for any reason in the past month (4 weeks)
• 14. Failure of a subject or the subject's substance abuse counselor to provide assent
• 15. Nutritional risk index of less than 95
• 16. Age \< 21 or \> 55 (using an age of 55 limits the likelihood of comorbid conditions that may increase the risk of adverse events with bronchoscopy)
• 17. Pregnancy
• 18. Decisionally challenged
• 19. Prisoners.
• 1. History of inhaled cannabis exposure EXCEEDING one "joint year" or positive urine toxicology screen (for cannabis)
• 2. History of inhaled tobacco product exposure EXCEEDING one "pack year" or a positive urine cotinine screen
• 3. Elevated AUDIT-C score: A 3 item questionnaire to identify subjects with alcohol use disorders.
• 4. Prior medical history of liver disease: cirrhosis, total bilirubin \> 2.0 mg/dL or albumin \<3
• 5. Prior medical history of myocardial infarction or congestive heart failure
• 6. Prior medical history of end-stage renal disease or serum creatinine \>3 mg/dL
• 7. Prior history of or current use of illicit drug use defined as a positive toxicology screen for opiates or cocaine
• 8. Prior history of diabetes mellitus
• 9. Prior history of chronic obstructive pulmonary disease (COPD) or asthma that is not clinically controlled (have not required systemic corticosteroids in the past month)
• 10. Prior history of HIV, not controlled or on medication
• 11. Peripheral white blood cell count of less than 3000
• 12. Acute worsening (\<7 days) in respiratory symptoms (such as change in cough frequency or sputum production, fever, dyspnea, abnormal chest radiograph), or room air pulse oximetry of \< 92% at rest or spirometry of \< 50% predicted for FEV1 and FVC
• 13. Use of systemic antibiotics in the past month (4 weeks)
• 14. Failure of a subject or the subject's substance abuse counselor to provide assent
• 15. Nutritional risk index of less than 95
• 16. Age \< 21 or \> 55
• 17. Pregnancy
• 18. Decisionally challenged
• 19. Prisoners.