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Smoking, vaping or eating marijuana is linked to a significantly higher risk of heart attack and stroke, even if a person had no existing heart conditions and did not smoke or vape tobacco, a new study found.

While both daily and non-daily users had an increased risk of heart attack and stroke compared to nonusers, stroke risk rose 42% and the risk of heart attack rose 25% if cannabis was used daily, the study found. The risk climbed as the number of days of use of marijuana rose.

“Cannabis smoke is not all that different from tobacco smoke, except for the psychoactive drug: THC (tetrahydrocannabinol) vs. nicotine,” said lead study author Abra Jeffers, a data analyst at Massachusetts General Hospital in Boston who researches tobacco and smoking cessation.

“Our study shows that smoking cannabis has significant cardiovascular risks, just like smoking tobacco. This is particularly important because cannabis use is increasing, and conventional tobacco use is decreasing,” Jeffers said in a statement.

The study’s findings mirror other research that has found daily use of marijuana is linked to an increase in coronary heart disease, heart attack and stroke, said Robert Page II, a professor of clinical pharmacy and physical medicine at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora, Colorado.

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Marijuana smoke contains many of the “same toxins, irritants and carcinogens as tobacco smoke,” according to the American Lung Association.

“The findings of this study have very important implications for population health and should be a call to action for all practitioners, as this study adds to the growing literature that cannabis use and cardiovascular disease may be a potentially hazardous combination,” Page said in a statement.

Page, who was not involved in this study, chaired the volunteer writing group for a 2020 scientific statement on medical and recreational marijuana use and cardiovascular health.

The danger is real for young and old alike

The study, published Wednesday in the Journal of the American Heart Association, analyzed data on 430,000 adults collected from 2016 through 2020 through the Behavioral Risk Factor Surveillance System, a national phone survey performed each year by the US Centers for Disease Control and Prevention.

People in the survey ranged in age from 18 to 74, with an average age of 45. Nearly 90% of adults did not use marijuana, while more than 63% had never used tobacco. Among current marijuana users, nearly 74% reported smoking as the most common form of consumption; 4% were daily users, while 7% used less than daily. Nearly 29% of daily marijuana users and 44% of non-daily users never used tobacco cigarettes.

Younger adults — defined as men under 55 and women under 65 years old — who used marijuana had a 36% higher risk of coronary heart disease, heart attack and stroke regardless of whether they also used traditional tobacco products.

Previous research has already found a link between heart disease and marijuana use.

A February 2023 study found that using marijuana every day can raise a person’s risk of coronary artery disease by one-third compared with those who never partake. Coronary artery disease is caused by plaque buildup in the walls of the arteries that supply blood to the heart. Also called atherosclerosis, CAD is the most common type of heart disease, according to the CDC.

Two studies published in November found that older adults who don’t smoke tobacco but who use marijuana were at higher risk of both heart attack and stroke when hospitalized, while people who use marijuana daily were 34% more likely to develop heart failure.

Marijuana use is on the rise among older adults. A 2020 study found that the numbers of American seniors over 65 who smoke marijuana or use edibles increased twofold between 2015 and 2018.

The American Heart Association advises people to refrain from smoking or vaping any substance, including cannabis products, because of the potential harm to the heart, lungs and blood vessels.

“The latest research about cannabis use indicates that smoking and inhaling cannabis increases concentrations of blood carboxyhemoglobin (carbon monoxide, a poisonous gas), (and) tar (partly burned combustible matter) similar to the effects of inhaling a tobacco cigarette, both of which have been linked to heart muscle disease, chest pain, heart rhythm disturbances, heart attacks and other serious conditions,” Page told CNN in a prior interview.

“You need to treat this just like you would any other risk factor (for heart disease and stroke) and honestly understand the risks that you were taking,” he said.

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