Article Figures & Tables
Figures
- Figure 1
Flow chart of identified records.
- Figure 2
Urine levels of tetrahydrocannabinol (THC) and metabolites and subjective effects in participants passively exposed to marijuana smoke in an unventilated environment, 4-8 hours after exposure, by THC content.
Tables
Author/country Intervention Participant selection No. of participants Participant characteristics Reported outcomes Quality* Cone et al.,22 2015, United States Intervention: nonsmokers were exposed to marijuana smoke from participants smoking marijuana in controlled environment laboratory over 3 sessions; potency and ventilation of environment were changed between each session
Multiple trials: 1) 5.3% THC in unventilated environment, 2) 11.3% THC in unventilated environment, 3) 11.3% THC in ventilated environmentParticipant selection: recruited through newspaper advertisements, flyers posted on university campus and around community, and word of mouth
Inclusion criteria for smokers: self-reported use of cannabis at least 2 times per week during previous 90 d, negative results of testing for other illicit substances
Inclusion criteria for nonsmokers: healthy participants who self-reported lifetime cannabis use but had not used cannabis or any other illicit drug in previous 6 mo6 smokers NR THC level in oral fluid and whole blood, self-report of drug effects (Drug Effects Questionnaire visual analogue scale) 22 6 nonsmokers NR Cone et al.,23 2015, United States Intervention: nonsmokers were exposed to marijuana smoke from participants smoking marijuana in controlled environment laboratory over 3 sessions; potency and ventilation of environment were changed between each session
Multiple trials: 1) 5.3% THC in unventilated environment, 2) 11.3% THC in unventilated environment, 3) 11.3% THC in ventilated environmentParticipant selection: recruited through newspaper advertisements, flyers posted on university campus and around community, and word of mouth
Inclusion criteria for smokers: self-reported use of cannabis at least 2 times per week during previous 90 d, negative results of testing for other illicit substances
Inclusion criteria for nonsmokers: healthy participants who self-reported lifetime cannabis use but had not used cannabis or any other illicit drug in previous 6 mo8 smokers 3 women, 5 men, average age 29 (SD 6) yr, average BMI 25.6 Total cannabis use (weight), THC level in urine 22 18 nonsmokers 9 women, 9 men, average age 28 (SD 7) yr, average BMI 24.7 Cone et al.,19 1987, United States Intervention: nonsmokers were exposed to marijuana cigarette smoke (2.8% THC) under double-blind conditions
Multiple trials: 3 trials, 1 with 4 cigarettes and 2 with 16 cigarettesParticipant selection: NR
Inclusion criteria for nonsmokers: healthy, drug-free men with history of marijuana use who had 14 consecutive d of cannabinoid-free urine tests; 2 cannabis-naive men (members of research team)7 nonsmokers All men, average age 36 yr, average weight 74.7 kg Room air THC concentrations, THC level in urine 20 Cone et al.,25 1986, United States Intervention: nonsmokers were exposed to marijuana cigarette smoke (2.8% THC) under double-blind conditions
Multiple trials: 3 trials, 1 with 4 cigarettes and 2 with 16 cigarettesParticipant selection: NR
Inclusion criteria for nonsmokers: healthy, drug-free men with history of marijuana use who had 14 consecutive d of cannabinoid-free urine tests; 2 cannabis-naive men7 nonsmokers All men, average age 36 yr, average weight 74.7 kg THC level in urine (EMIT 20 ng/mL and 100 ng/mL) and whole blood, heart rate, blood pressure, subscales of Addiction Research Center Inventory (single-dose questionnaire, visual analogue scale) 22 Cone et al.,26 1986, United States Intervention: nonsmokers were exposed to marijuana cigarette smoke (2.8% THC) under double-blind conditions
Multiple trials: 3 trials, 1 with 4 cigarettes and 2 with 16 cigarettesParticipant selection: NR
Inclusion criteria for nonsmokers: healthy, drug-free men with history of marijuana use who had 14 consecutive d of cannabinoid-free urine tests; 2 cannabis-naive men7 nonsmokers All men, average age 36 yr, average weight 74.7 kg THC level in urine (EMIT 20 ng/mL and 100 ng/mL) and whole blood, subscales of Addiction Research Center Inventory (single-dose questionnaire, visual analogue scale, circular lights task, digit-symbol substitution task) 19 Herrmann et al.,24 2015, United States Intervention: nonsmokers were exposed to marijuana smoke from participants smoking marijuana in controlled environment laboratory over 3 sessions; unlimited marijuana was provided to smokers
Multiple trials: 1) 11.3% THC in unventilated environment, 2) 11.3% THC in ventilated environment (11 air exchanges per hour)Participant selection: recruited from Baltimore through media advertising and word of mouth
Inclusion criteria for smokers: age 18-45 yr, used cannabis at least 2 times per week during previous 90 d, urine sample positive for THC and negative for other drugs, negative breath alcohol reading at screening and on day of session, BMI 19-34, not pregnant or nursing
Inclusion criteria for nonsmokers: age 18-45 yr, cannabis use at least once but not during previous 6 mo, urine sample negative for all drugs, negative breath alcohol reading at screening and on day of session, BMI 19-34, not pregnant or nursing7 smokers 4 men, 3 women, average age 29.4 (SD 5.8) yr, average BMI 25.6 Total weight of cannabis smoked, THC level in blood and urine, heart rate, blood pressure, subscales of Drug Effects Questionnaire (divided attention task, digit-symbol substitution task, paced auditory serial addition task) 22 12 nonsmokers 3 men, 3 women, average age 28.7 yr, average BMI 25.3 Law et al.,27 1984, United Kingdom Intervention: nonsmokers were exposed to marijuana smoke (9.8% THC) in a small, unventilated room
Multiple trials: No
Timeline of exposure: after smokers had consumed their cannabis cigarette (which took 10-34 min), nonsmoking participants remained in room for 3 hParticipant selection: NR
Inclusion criteria for smokers: NR
Inclusion criteria for nonsmokers: NR6 smokers NR Environmental exposure (gas chromatography), THC level in urine and whole blood (radioimmunoassay) 13 4 nonsmokers NR Moore et al.,28 2011, United States Intervention: passive 3-h exposure to marijuana in Dutch "coffee shop"
Multiple trials: 2 trials in 2 different coffee shops, with varying numbers of active smokers (varying THC percentage)Participant selection: volunteers; selection strategy NR
Inclusion criteria for smokers: any active smoker in coffee shop during exposure timeline
Inclusion criteria for nonsmokers: healthy participants who did not smoke marijuana16 smokers in trial 1, 6 smokers in trial 2 NR Air cannabinoid content (Quantisal collection device), THC level in oral fluid (Quantisal collection device) 19 10 nonsmokers 5 men, average age 22.8 yr, average weight 84 kg, average height 1.9 m, average BMI 233; 5 women, average age 23.8 yr, average weight 62.4 kg, average height 1.71 m, average BMI 21.2 Mørland et al.,33 1985, Norway Intervention: participants were exposed to marijuana and hashish smoke in small, unventilated car
Multiple trials: 1) hashish (1.5% THC), 2) marijuana (1.5% THC)Participant selection: volunteers; selection strategy NR
Inclusion criteria for smokers: NR
Inclusion criteria for nonsmokers: healthy cannabis-naive participants5 smokers NR Blood cannabinoid levels (radioimmunoassay), THC level in urine (EMIT) 16 10 nonsmokers 7 men, 3 women "of normal weight in relation to their height, age, and sex" Mulé et al.,29 1988, United States Intervention: in first part of experiment, smokers were asked to smoke cannabis as they usually did and were observed; in second part, nonsmokers were exposed to smoke of 4 cannabis cigarettes (27 mg THC) in unventilated room
Multiple trials: noParticipant selection: NR
Inclusion criteria for smokers: occasional (1 cigarette/wk) or moderate (1-3 cigarettes/wk) smoking
Inclusion criteria for nonsmokers: NR8 smokers All male, age 21-27 yr, height 5'9"-6'1" (1.75-1.85 m), weight 154-175 lbs (69.8-79.4 kg) THC level in urine (EMIT) 18 3 nonsmokers NR Niedbala et al.,20 2005, United States Intervention: participants were placed in severe second-hand smoke conditions in unventilated van for 1 h
Multiple trials: 2 trials, each with 4 smokers and 4 passive inhalers; 5.4% THC in trial 1, 10.4% THC in trial 2Participant selection: volunteers; recruitment strategy NR
Inclusion criteria for smokers: healthy white men who reported infrequent past cannabis use
Inclusion criteria for nonsmokers: healthy white men who tested as cannabis-free before study based on oral fluid and urine tests and self-reported data8 smokers 18-24 yr for both groups THC level in oral fluid (Intercept collector pads) and urine 16 8 nonsmokers 34-50 yr in first group, 25-50 yr in second group Niedbala et al.,21 2004, United States Intervention: smokers consumed 1 cannabis cigarette each (approximate THC level 1.75%) in presence of nonsmokers in sealed room
Multiple trials: noParticipant selection: volunteers; recruitment strategy NR
Inclusion criteria for smokers: healthy white men who reported infrequent prior use of cannabis
Inclusion criteria for nonsmokers: healthy white men who tested as cannabis-free before start of study5 smokers Age 21-25 yr Air cannabinoid content, THC level in oral fluid and urine 15 4 nonsmokers Age 37-49 yr Perez-Reyes et al.,30 1983, United States Intervention: smokers consumed cannabis cigarettes in presence of nonsmokers in a room (trials 1 and 3) and a car (trial 2); biological samples were then taken and compared between the 2 groups
Multiple trials: 1) 2 cigarettes (2.5% and 2.8% THC), 2) 2 cigarettes (2.8% THC), 3) 4 cigarettes (2.8% THC)Participant selection: NR
Inclusion criteria for smokers: experienced marijuana users
Inclusion criteria for nonsmokers: marijuana-naive participants6 smokers 3 men, 3 women, "healthy and of normal weight and height in relation to their age and sex" THC presence in air, THC level in urine (EMIT) and blood 16 6 nonsmokers 3 men, 3 women, "healthy and of normal weight and height in relation to their age and sex" Röhrich et al.,31 2010, Germany Intervention: nonsmokers were exposed to marijuana smoke in Dutch coffee shop with ventilation (THC percentage NR)
Multiple trials: noParticipant selection: NR
Inclusion criteria for smokers: active smoker in coffee shop at time of experiment
Inclusion criteria for nonsmokers: no history of cannabis use, no contact with cannabis in month preceding experiment8-25 smokers at a time NR THC level in blood and urine (gas chromatography-mass spectrometry) 15 8 nonsmokers 4 men, 4 women Zeidenberg et al.,32 1977, United States Intervention: heavy marijuana smokers consumed cannabis (THC level NR) in presence of placebo smoker in locked ward
Multiple trials: noParticipant selection: NR
Inclusion criteria for smokers: NR
Inclusion criteria for nonsmoker: NR5 smokers NR THC level in urine, subjective reporting, physical examination 14 1 nonsmoker NR Note: BMI = body mass index, EMIT = enzyme multiplied immunoassay technique, NR = not reported, SD = standard deviation, THC = tetrahydrocannabinol.
*Assessed with the use of the Downs and Black checklist,17 which rates papers on 5 constructs: 1) reporting, 2) external validity, 3) internal validity - bias, 4) internal validity - confounding and 5) power. A total score of 24-28 points = excellent, 19-23 points = good, 14-18 points = fair, less than 14 points = poor.18
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