Cannabis Use and Risk of Chronic Rhinosinusitis and Sinus Surgery

Objective While cannabis' link to asthma is well‐studied, its impact on CRS is less clear. This study explores the association between cannabis use and rates of new‐onset chronic rhinosinusitis (CRS), chronic rhinosinusitis with nasal polyps (CRSwNP), and functional endoscopic sinus surgery (FESS) rates. Methods The TriNetX Analytics Research Network was queried for adults ≥ 18 years old, stratified into cannabis user and non‐user cohorts based on electronic health record data from January 2012 to December 2019. Separate cohorts of patients with pre‐existing CRS—with and without cannabis use—were analyzed to evaluate associations with FESS. Primary outcomes were relative risks of new‐onset CRS and CRSwNP encounter diagnosis and FESS 1, 2, and 5 years after initial cannabis use diagnosis. Results After 1:1 propensity score matching, cohorts analyzing CRS and CRSwNP included 73,091 patients each. Cannabis use was associated with reduced risk of unspecified CRS at 1 year (aRR = 0.87, 95% CI 0.80–0.95), 2 years (aRR = 0.84, 95% CI 0.78–0.90), and 5 years (aRR = 0.83, 95% CI 0.78–0.87). There was no difference in risk of CRSwNP at any timepoints. For FESS outcomes, matched cohorts included 5591 patients with pre‐existing CRS; cannabis users had lower risk at 1 year (aRR = 0.67, 95% CI 0.47–0.96), 2 years (aRR = 0.64, 95% CI 0.46–0.88), and 5 years (aRR = 0.69, 95% CI 0.52–0.91). Conclusions Patients with cannabis use demonstrated significantly reduced risks in new‐onset diagnoses of CRS and FESS compared to non‐users. Further studies are warranted to examine the cause of this relationship. Level of Evidence 4.