A groundbreaking new study has sent shockwaves through the medical and public health communities by revealing that cannabis use could be more dangerous for the heart than cocaine. The research, published recently in the esteemed journal Heart, synthesizes data from over 432 million individuals and challenges widespread perceptions about the safety of cannabis, especially as legalization expands globally. For Thailand, where decriminalization and policy debates about cannabis are accelerating, the study’s findings carry urgent implications for users and policymakers alike.
For decades, cannabis has been promoted as a natural, relatively harmless remedy for relaxation, pain relief, and a broad range of medical indications. It is widely used in Thai pharmacies, wellness resorts, and even traditional medicine. However, this latest international study demonstrates that regular cannabis use substantially increases the risks of heart attack, stroke, and fatal cardiovascular events. Strikingly, the data suggests these risks are higher than those associated with cocaine—a drug historically vilified for its cardiac effects.
The authors of the new study based their conclusions on a massive analysis of existing research: 3,012 studies in total, with 24 meeting strict criteria for establishing connections between cannabis and major cardiovascular events. The analysis found that cannabis users were 29% more likely to have a heart attack, 20% more likely to suffer a stroke, and more than twice as likely to die from heart disease, compared with non-users. These results held even after statistically adjusting for tobacco, alcohol, and other drug use such as cocaine. In a large French hospital study, cannabis emerged as a stronger predictor of heart attacks in young people than cocaine, upending conventional narratives around recreational drug harms (Earth.com; Heart - BMJ; CNN; CBS News; UCSF).
One of the most disturbing findings is the heightened risk among young users. Multiple studies reviewed found teenagers and young adults who used cannabis regularly were up to 36% more likely to have a heart attack and up to five times more likely to experience a stroke compared to their peers. In a particularly sobering twist, a 2024 UK-based study revealed that women faced even greater risks of dying from heart disease linked to heavy cannabis use—a critical insight for public health targeting among Thai women (Earth.com).
The reasons for these elevated risks are multifaceted. Modern cannabis products tend to be more potent than those available in prior decades, with higher concentrations of THC—the main psychoactive compound known to impact both brain and heart. Increased legalization in North America and Europe has also spawned a wave of potent concentrates, synthetic cannabinoids, edibles, and vaporizable forms, potentially exposing users to a cocktail of risk factors, including particulate matter and terpenes that may independently harm cardiovascular tissue (UCSF; Heart - BMJ).
These findings directly challenge the common Thai perspective that, because cannabis is natural and used medicinally, it is largely safe. While it is true that cannabis possesses clinically proven benefits—such as pain relief for chronic conditions, antiemetic effects for cancer patients, and seizure reduction in select paediatric epilepsies—researchers emphasize that these therapeutic advantages must be carefully balanced against emerging cardiovascular harms. According to a professor of medicine cited in several international reports, “Medical cannabis is not risk-free, and its growing use in increasingly concentrated formulations warrants robust public health interventions.”
What does this mean for Thailand, a nation at the forefront of progressive cannabis policy in Asia? In 2022, Thailand became the first country in the region to legalize cannabis, positioning itself as a leader in medical cannabis cultivation and tourism. Since then, large numbers of Thais and tourists have experimented with cannabis in various forms, from teas and edibles to smoking and oils. Yet, unlike tobacco, where public awareness of heart risks is high and secondhand smoke regulations exist, warnings about cannabis’s cardiovascular dangers remain largely absent from Thai public policy and commercial practices.
Given new evidence, leading cardiologists and public health officials worldwide are calling for cannabis to be regulated with the same rigor as tobacco. This position is echoed by international experts such as Professor Stanton Glantz, who argued: “Cannabis should be treated like tobacco—not criminalized, but actively discouraged for non-medicinal use, with clear warnings and efforts to protect bystanders from second-hand exposure.” Furthermore, medical practitioners are being urged to screen patients for cannabis use during consultations about heart health and to provide honest risk information (Earth.com; CBS News).
Thai policy makers now face a crossroads. While cannabis decriminalization has fueled economic activity, created jobs, and drawn tourists seeking wellness experiences, its unregulated legalization—especially among young people—could create a looming public health crisis. The Thai Ministry of Public Health has acknowledged the risk of product misuse but, to date, has yet to impose mandatory health warnings or robust public education campaigns about cardiovascular dangers. The lack of comprehensive registry data on hospitalizations and deaths related to cannabis means the true domestic risk may be underestimated.
Drawing parallels from tobacco control history is instructive. Decades of evidence finally compelled the introduction of mandatory warning labels, advertising restrictions, and taxation regimes for cigarettes in Thailand. Similar measures may be necessary for cannabis: health warnings on all cannabis products, limits on potency, bans on marketing to minors, and strict enforcement against public smoking. Additionally, because cannabis is now readily available in tourism hotspots such as Chiang Mai, Phuket, and Bangkok, a coordinated education campaign targeted at both locals and international visitors could prevent significant downstream health costs.
It is also important to recognize that risk perception plays a significant role in shaping user behavior. Surveys conducted in the US and Europe suggest that, despite legalization, many young users still underestimate the harms of cannabis compared with other illicit drugs. In Thailand, where traditional medicine and Buddhist philosophy often encourage moderation, there is potential for culturally resonant harm-reduction campaigns. Monastic organizations, respected medical personnel, and community health workers could all become advocates for responsible messaging around emerging risks.
Thailand’s role as a medical tourism and cannabis hub also means that international trends in health risk management are especially relevant. In countries such as Canada and parts of the United States, public information campaigns and regulatory frameworks are being updated in response to research like that published in Heart. Likewise, European health authorities are debating new restrictions as fresh evidence emerges (Heart - BMJ).
Looking ahead, researchers emphasize several crucial avenues for action. First, additional local studies are urgently needed to understand the unique risk profile among Thai cannabis users, factoring in differences in consumption methods, potency, and genetic predisposition to cardiovascular disease. Second, the development of THC and other compound biosensors in Thai health clinics could help monitor exposure in high-risk individuals. Third, regulatory authorities must consider immediate labeling rules and enforce point-of-sale educational requirements for dispensaries and online cannabis shops.
For ordinary Thai readers, these findings should prompt several practical steps. Users—especially young adults and pregnant women—should limit both the frequency and potency of cannabis products, and seek medical advice if they have a personal or family history of cardiovascular disease. Those already living with heart conditions should be candid with their healthcare providers about cannabis use and avoid concurrent consumption of other drugs, including tobacco or cocaine, which can further magnify harms. Families and educators have a responsibility to model informed, moderate attitudes and discuss the evolving scientific consensus.
While cannabis remains a valuable medicinal resource for specific patients under medical supervision, the myth of its universal safety must be reconsidered in light of robust new data. As Thailand shapes the next stage of its cannabis policy journey, transparent communication, evidence-based regulation, and culturally sensitive education will be key to safeguarding the health of present and future generations (Earth.com; Heart - BMJ; CNN; CBS News; UCSF).