Colorado Marijuana Users Health Cohort

In Colorado, marijuana is currently used for both recreational and medicinal purposes. The
major active drug is tetrahydrocannabinol (THC). The most common route of use is through
inhalation of the combustion products of the dried, buds/flowers from the female plant either
rolled in paper (joint) or burned through a screen in a dry or water filled pipe (bong).
Increasingly THC is consumed.

The side effects of the inhalation of burned leaves are controversial. The purpose of this
proposal is to establish a prospective cohort of heavy marijuana users to evaluate positive
and negative long term medical effects of marijuana use. As marijuana has also been reported
for use to help treat insomnia, a sub-study will focus on how marijuana is used for sleep
disorders and disturbances.

This study will enroll individuals that use marijuana to learn more about long-term health
effects. The study involves one visit where participants will complete questionnaires,
breathing tests, blood and urine collection. There is a sub-study where eligible participants
will also complete an at-home sleep monitoring test. Participants will be contacted multiple
times a year for long-term follow-up.

Inclusion Criteria:

- Colorado-only study

- Age 21-80 years and one of the categories below

- Marijuana use: use of any cannabis (smoked, vaped, edible, etc.) on average more than
3 days per week for at least 1 year

- Combined marijuana use and Tobacco use (current or former): ≥ 30 pack year cigarette
smoking history

- Non-marijuana users

Sleep sub-study:

Enrollment in the main cohort building study and a qualifying score on the Insomnia
Severity Index questionnaire

Exclusion Criteria:

- Respiratory disorder other than COPD or asthma

- Lung surgery with removal of a lobe or more or lung volume reduction surgery

- Lung cancer or other cancer under active treatment during past 12 months

- ≥ 30 pack year cigarette smoking history for combined marijuana and cigarette users

- Pregnancy

- Use of antibiotics and/or systemic steroids for any lung infection within the last
month

- Inability to use albuterol

- Subject enrolled in COPDGene or SPIROMICS

Sleep sub-study:

- Inability to complete home sleep study