Robert Page, a professor in the Departments of Clinical Pharmacy and Physical Medicine at the University of Colorado, joins Tim to talk about some new developments in determining significant cardiovascular risks associated with marijuana use, regardless of the reason. He’s the lead author on a new paper from the American Heart Association that exposes major risks. We talk about his paper, some of the myths surrounding medical marijuana usage, and what it all means.

If I were to use a term with you, a propaganda term, do you think you’d fall for it?  Let’s give it a shot. So, here’s the term. What do you think of when I say, “medical marijuana?”

Now, before we go any further, I need to give you a quick history lesson on the field where I work. I work in public relations. The founding fathers of this field actually called it the practice of propaganda back in those early days. And they weren’t wrong. Some 100 years ago, propagandists sold everything from war bonds to cigarettes, from oil and gasoline to railroad travel. And when something went wrong, they became spin doctors. They played with the truth, and it wasn’t always ethical.

Since then, the field has done much to improve its own image by establishing ethical standards, but this doesn’t mean that “spin” has just faded away. The battle over the truth is never-ending.

If you can believe this, back in the 1930s and 40s, the advertising and public relations fields convinced Americans that smoking cigarettes was actually good for their health.

At that time, the medical community had not yet discovered the link between smoking and lung cancer or lung disease. In fact, most doctors smoked cigarettes.

Of course, there was evidence all around them that lung cancer was on the rise, but no one blamed cigarettes at first.

Some tobacco companies even used doctors in their ads. American Tobacco was the maker of Lucky Strike cigarettes. In 1930, the company created an ad that said, “20,679 Physicians say ‘LUCKIES are less irritating’” to the throat of a smoker.

To arrive at this conclusion, American Tobacco’s advertising agency sent cartons of Lucky Strike cigarettes to doctors along with a letter. That letter asked those doctors whether they believed Lucky Strike cigarettes were “less irritating to sensitive and tender throats than other cigarettes.” To make sure they got the results they wanted, the letter that “a good many people” had already said Lucky Strikes were less irritating.

In the end, millions of Americans came to believe that cigarettes have a medicinal effect.

By 1937, the Philip Morris weighed in with an ad in the Saturday Evening Post. Keep in mind, that magazine was extremely dominant and powerful in influencing public opinion throughout the United States at the time.

The Philip Morris ad said the company did a study that showed “when smokers changed to Philip Morris, every case of irritation cleared completely and definitely improved.”  The ad never mentioned the business relationship the company had with those doctors.

For years, tobacco companies made claims in their advertising and marketing that smoking cigarettes are healthy, and if not good for you, the ads certainly never hinted that cigarettes could be bad for you.

The R.J. Reynolds Tobacco Company even created a Medical Relations Division and promoted it through medical journals. That company paid for its own research to demonstrate the medicinal benefits of cigarette smoking.

In 1946, R.J. Reynolds created a new ad campaign under the slogan, “More doctors smoke Camels than any other cigarette.”

We talk to someone who knows a lot more than I do on this. Robert Page is the lead author on a new scientific paper called: “Medical Marijuana, Recreational Cannabis, and Cardiovascular Health: A Scientific Statement from the American Heart Association.”

Links

• Robert Page Website (University of Colorado)
• Robert Page Bio (Heart Failure Society of America)
• Marijuana Use Linked with Increased Risk of Heart Attack, Stroke (American Heart Association)
• Marijuana Use Raises Risk of Heart Attack, Heart Failure and Stroke, Studies Say (CNN)

About this Episode’s Guest Robert Page

Robert Page, PharmD, MSPH, BCPS (AQ-cards), BCGP, FAHA, FHFSA, FCCP, FASHP is a Professor in the Departments of Clinical Pharmacy, Medicine, and Physical/Rehabilitative Medicine at the University of Colorado Denver, Schools of Pharmacy and Medicine (Aurora), and the clinical pharmacy specialist for the Division of Cardiology Section of Advanced Heart Failure and Heart Transplantation. He developed and is currently the Clinical Lead for the Colorado Evidenced Based Drug Utilization Program, which manages the safe and efficacious use of medications for more than 1 million Medicaid beneficiaries.

Dr. Page received his bachelor of science degree in biology and chemistry from Furman University (Greenville, SC); bachelor of science in pharmacy and Pharm.D. degrees from the Medical University of South Carolina (MUSC; Charleston); Masters of Science in Public Health with an epidemiology focus from the University of Colorado School of Medicine (Denver); and a specialty residency in pharmacotherapy with a focus in cardiology from MUSC. He is a board-certified pharmacotherapy specialist with added qualifications in cardiology, a Board-Certified Geriatric Pharmacist, and a Fellow of the following organizations: the Heart Failure Society of America, the American College of Clinical Pharmacy, the American Heart Association (Council on Clinical Cardiology), the American Society of Consultant Pharmacists, and the American Society of Health-System Pharmacists.

Dr. Page has either chaired or served on numerous AHA, HFSA, and ACC committees and was the first chair of the Clinical Pharmacology Subcommittee of the AHA Council on Clinical Cardiology, has been an external reviewer for several/AHA cardiovascular management guidelines and writing chair for two AHA Clinical Science Statements. Dr. Page has 25 years of clinical expertise in the management of patients with heart failure in both the outpatient and inpatient setting. He has published over 200 peer-reviewed manuscripts, abstracts, and book chapters in the management of patients with cardiovascular disease.

During his time at the University of Colorado, he has trained over 100 pharmacy residents/fellows and has been honored with multiple School and University teaching awards. In 2013, he was honored with the ACCP Clinical Practice Award due to his dedication to advancing the profession.