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Several pulmonary studies enrolled cannabis-only groups and demonstrate large-airway dysfunction and symptomatology independent of tobacco (9,11), while population cohorts show non-linear lung-function patterns with cannabis exposure after tobacco adjustment (13) and increased odds of airflow obstruction at very high lifetime use (64)

The 2025 edition shows that 46 countries have seen their situation worsen, 34 have made progress, and only 18 have adopted new measures or strengthened the implementation of Article 5.3 across all their administrations

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