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Concurrent use of both cannabis and tobacco was associated with increased risk (even adjusted for age, asthma, and comorbidities) of respiratory symptoms (OR 2.39, 95% CI 1.583.62) and COPD (OR 2.90, 95% CI 1.535.51) if the lifetime dose of marijuana exceeded 50 marijuana cigarettes

Acute or chronic disturbances of liver function may necessitate the discontinuation of COC use until markers of liver function return to normal and COC causation has been excluded

Avoid overstuffing the joint as this can make rolling and smoking more challenging

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