Unexpected findings add new insight on cannabis and heart health
UCSF trial found fewer premature heartbeats after cannabis inhalation, with potential implications for atrial fibrillation risk
University of California - San Francisco
Habitual cannabis users experienced about 9% fewer premature heartbeats on days they inhaled cannabis compared with days they abstained, a counterintuitive finding that adds to the complex and evolving understanding of how cannabis affects the heart, new UC San Francisco-led research found.
The study, published Aug. 12 in the Journal of the American College of Cardiology, is among the first to examine the acute cardiovascular effects of inhaled cannabis in people living their normal daily lives. While the findings challenge assumptions drawn largely from observational studies, the researchers caution these findings should not influence medical or behavioral decisions around cannabis use.
With millions of Americans using cannabis, studies like this are increasingly important to understand its health effects, said researchers.
"We were surprised by the results because they contradicted our original hypothesis," said Gregory Marcus, MD, MAS, an endowed professor in atrial fibrillation research in the UCSF Division of Cardiology. "That's why randomized trials are so important. When the data challenge our expectations, our job as scientists is to understand them, not ignore them."
The trial enrolled 108 adults who regularly smoked or vaped cannabis but had no history of clinically diagnosed cardiac arrhythmias. Over 14 days, participants were randomly assigned each day to either inhale cannabis or abstain while wearing a continuously recording electrocardiographic monitor, activity tracker, sleep monitor, and continuous glucose monitor. Participants served as their own control, allowing investigators to compare physiological changes during cannabis-use and abstinence days.
Greatest predictor of premature atrial contractions
Unlike previous studies that relied largely on participants' self-reports or medical records, this randomized crossover trial, the gold standard for trials, continuously monitored every heartbeat, enabling researchers to measure physiological changes in real time under everyday conditions.
Researchers found that cannabis inhalation was associated with a statistically significant reduction in extra or early heartbeats, knowns as cardiac ectopy. The reduction was driven by fewer extra heartbeats that began in the heart's upper chambers, known as premature atrial contractions (PACs). The frequency of PACs is the single most potent predictor of atrial fibrillation, while PVCs can predict heart failure. Although these early heartbeats are common, researchers still know relatively little about what determines their frequency.
No significant change was observed in extra heartbeats originating in the lower chambers, called premature ventricular contractions (PVCs).
The researchers found no significant differences in daily step counts, sleep duration, or glucose levels, also surprising. Together, the findings illustrate how randomized trials can produce a different and more nuanced picture than observational research alone.
Marcus emphasized that the findings should not be interpreted as evidence that cannabis benefits cardiovascular health.
"This study examined the acute effects of cannabis in people who use it regularly and was not designed to evaluate the long-term health consequences," he said. "The overall health effects of inhaled cannabis may still be net negative, but these findings suggest there may be something about cannabis that can teach us more about the biological mechanisms that produce premature atrial contractions. That knowledge could eventually lead to new approaches for preventing or treating abnormal heart rhythms."
Authors: In addition to Gregory M. Marcus, MD, MAS, the study authors are Adi Elias, MD, MPH; Gabrielle C. Montenegro, BA; Hannah H. Oo, BS; Isabella J. Peña, BA; Dylan A. Lowe, PhD; Catherine Lee, PhD; Janet Tang, PhD; Kara L. Lynch, PhD; Lilly Lim, BS; Mirna Maamou, BS; Nhung Nguyen, PhD; and Matthew L. Springer, PhD, of UC San Francisco.
Funding: The research was supported by the UCSF Cardiology Scholars & Innovation Award. Dexcom donated continuous glucose monitors used in the study.
Disclosures: The authors report no relevant conflicts of interest or disclosures.
About UCSF: The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health, which serves as UCSF’s primary academic medical system, includes top-ranked specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area. UCSF School of Medicine also has a regional campus in Fresno. Learn more at ucsf.edu.
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Journal
Journal of the American College of Cardiology
Method of Research
Randomized controlled/clinical trial
Subject of Research
People
Article Title
Acute Effects of Cannabis Inhalation on Cardiac Ectopy, Physical Activity, Sleep, and Glucose
Article Publication Date
12-Aug-2026
Smokers still largely unaware of heart disease risks
A new study covering 46 countries found significant gaps in awareness about smoking and second-hand smoke
An international study has found that despite two decades of global tobacco control efforts, the message still is not getting through to enough smokers that smoking and second-hand smoke cause heart attack and stroke.
Researchers at the University of Waterloo and the Global Tobacco Control Program at the U.S. Centers for Disease Control and Prevention (CDC) conducted the study, which is the largest of its kind.
Tobacco use is the leading preventable cause of disease and death worldwide. Up to two-thirds of people who smoke throughout their lives die from a smoking-caused disease, and lose more than a decade of life, on average.
The research team analyzed data from more than 240,000 adult smokers across 46 countries over two decades. While more than 90 per cent knew that smoking causes lung cancer, only about 80 per cent knew it causes heart disease or heart attack and 70 per cent knew it causes stroke. In several high-income countries — including Australia, Germany, England, the U.S., New Zealand, and Canada — fewer than half of adults who smoke knew that second-hand smoke causes heart disease or heart attack. China, a country of 300 million smokers, was among the countries where awareness was lowest.
“Knowledge gaps about the major health effects of smoking and second-hand smoke are deeply concerning,” said Dr. Janet Chung-Hall, Research Scientist for the International Tobacco Control Policy Evaluation Project (ITC Project) at Waterloo and the lead author of the study. “The low awareness of the cardiovascular harms of smoking and second-hand smoke is particularly troubling given that smoking causes more than 2 million cardiovascular deaths worldwide each year. Increasing public awareness of these risks should be a greater public health priority.”
Across two decades, the study found almost no progress in knowledge of the health risks of smoking and second-hand smoke. Although knowledge about the cardiovascular risks of smoking and second-hand smoke increased in some countries, including Bangladesh, India, Thailand and Vietnam, knowledge of those second-hand smoke risks actually decreased in the majority of high-income countries studied, including Canada, the U.S., New Zealand, England, and Japan.
The study also examined knowledge about lung cancer, finding that although about 90 per cent knew that smoking causes lung cancer, fewer knew that secondhand smoke does, with little progress over time.
“Knowledge is an important first step toward quitting smoking and protecting others from second-hand smoke,” said Dr. Geoffrey T. Fong, Principal Investigator of the ITC Project and University Professor of Psychology and Public Health Sciences at Waterloo. “Our findings highlight the need for governments to implement stronger, sustained public education about the cardiovascular as well as cancer risks of smoking and second-hand smoke. Policies such as large pictorial warnings and sustained media campaigns can increase awareness, encouraging quitting among those who smoke and discouraging young people from starting to smoke.”
Those policies are part of the global tobacco control treaty, the WHO Framework Convention on Tobacco Control, to which more than 180 countries are signatories.
The study appears in BMJ Open.
Journal
BMJ Open
Method of Research
Data/statistical analysis
Subject of Research
People
Article Title
Smokers still largely unaware of heart disease risks
Article Publication Date
4-Aug-2026
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