Cannabinoid hyperemesis syndrome

[slozukimc]

Wow. I have been battling very similar symptoms over the last few years. I don't have time to post the whole story right now but the only thing missing is the hot showers. I, on the other hand, MUST have a drink of hot coffee every morning to keep the nausea from being so bad that I vomit. Eating usually helps after I have the coffee. It seems to be only a few sips to make it back off. Usually a bong rip makes it go away as well. I have been hospitalized with flu like symptoms with no diagnosis twice in two years. The only time anyone mentioned any possibility of a cause was one nurse took me to the side and told me that she knows I smoke a lot(it's a small town thing) and that I should do research about it. She didn't recall the name but it appears she was speaking of CHS. I have been a very heavy user for 30 years. A half a Z a week easy most of the time. All of the herb is homegrown and all organic. Don't ask how I know because I can't say but it is. I take nexium every day or the heartburn is unbearable. I have read every word of every post here so far and intend to continue reading as much as I can find on the subject.
I am not saying CHS is what is wrong with me but the similarities are uncanny.
I am questioning the combustion and or the fact that I know that the herb is NOT cured long enough. It's always gone too fast. I have quit use of that herb and combustion entirely as of today. I have a Hercules oil attachment so I can vape some low temp hits to keep the nausea at bay. I also have da Buddha but don't want to use that until I have another herb to try in it. I know it is not scientific to eliminate more than one variable at a time but I figure if all of the symptoms go away I can reintroduce the herb without combustion and see what happens. Another thing I recall is that I don't remember ever having heartburn before I started using weed when I was 17 but, I do recall eating Rolaids by the roll for years until the doctor prescribe the Nexium daily for GERD symptoms since I started smoking. I started weed and cigarettes about the same time period. I have since quit cigs several times and will never start those damned things again. I have finally programmed my mind to hate the smell and taste enough to ignore the cravings.
A few years ago I had the idea to only vape. I really enjoy a bong and the social aspect of smoking with friends made it very difficult for me to abstain from combusting so I didn't. I am a bit of an introvert until I catch one and then people don't make me feel so uncomfortable and I can converse freely. I recall feeling great during that time period and never really put it together until over the last few days.

I will be keeping an eye on this thread and any others I find. I have yet to read through all of the links provided here but I will soon. I apologize for the random nature of my post. I tend to type as I recall and sometimes it is out of order.

Here's hoping that I and others can find a happy medium with our favorite herb and keep these symptoms away. The last time this flared up on me was New Year's Eve. I drank a bit but nowhere near what I can consume without trouble and after smoking with some folks I was violently ill and had to come home early. I have not felt good since. I hesitate to go see the doc as I am sick of being told there is nothing wrong with me. I hate pills and big pharmaceutical companies so when they try to push random meds on me that I know don't work I tell them so. I tell them that I cannot take NSAID type pain relievers as they upset my stomach. Apparently that makes me a pill seeker in their eyes. Apparently you are not supposed to know anything about what not to take.

Ok. Enough rambling for now.

Thanks for listening, Mike

 

[Glass004]

Wow. I have been battling very similar symptoms over the last few years. I don't have time to post the whole story right now but the only thing missing is the hot showers. I, on the other hand, MUST have a drink of hot coffee every morning to keep the nausea from being so bad that I vomit. Eating usually helps after I have the coffee. It seems to be only a few sips to make it back off. Usually a bong rip makes it go away as well. I have been hospitalized with flu like symptoms with no diagnosis twice in two years. The only time anyone mentioned any possibility of a cause was one nurse took me to the side and told me that she knows I smoke a lot(it's a small town thing) and that I should do research about it. She didn't recall the name but it appears she was speaking of CHS. I have been a very heavy user for 30 years. A half a Z a week easy most of the time. All of the herb is homegrown and all organic. Don't ask how I know because I can't say but it is. I take nexium every day or the heartburn is unbearable. I have read every word of every post here so far and intend to continue reading as much as I can find on the subject.
I am not saying CHS is what is wrong with me but the similarities are uncanny.
I am questioning the combustion and or the fact that I know that the herb is NOT cured long enough. It's always gone too fast. I have quit use of that herb and combustion entirely as of today. I have a Hercules oil attachment so I can vape some low temp hits to keep the nausea at bay. I also have da Buddha but don't want to use that until I have another herb to try in it. I know it is not scientific to eliminate more than one variable at a time but I figure if all of the symptoms go away I can reintroduce the herb without combustion and see what happens. Another thing I recall is that I don't remember ever having heartburn before I started using weed when I was 17 but, I do recall eating Rolaids by the roll for years until the doctor prescribe the Nexium daily for GERD symptoms since I started smoking. I started weed and cigarettes about the same time period. I have since quit cigs several times and will never start those damned things again. I have finally programmed my mind to hate the smell and taste enough to ignore the cravings.
A few years ago I had the idea to only vape. I really enjoy a bong and the social aspect of smoking with friends made it very difficult for me to abstain from combusting so I didn't. I am a bit of an introvert until I catch one and then people don't make me feel so uncomfortable and I can converse freely. I recall feeling great during that time period and never really put it together until over the last few days.

I will be keeping an eye on this thread and any others I find. I have yet to read through all of the links provided here but I will soon. I apologize for the random nature of my post. I tend to type as I recall and sometimes it is out of order.

Here's hoping that I and others can find a happy medium with our favorite herb and keep these symptoms away. The last time this flared up on me was New Year's Eve. I drank a bit but nowhere near what I can consume without trouble and after smoking with some folks I was violently ill and had to come home early. I have not felt good since. I hesitate to go see the doc as I am sick of being told there is nothing wrong with me. I hate pills and big pharmaceutical companies so when they try to push random meds on me that I know don't work I tell them so. I tell them that I cannot take NSAID type pain relievers as they upset my stomach. Apparently that makes me a pill seeker in their eyes. Apparently you are not supposed to know anything about what not to take.

Ok. Enough rambling for now.

Thanks for listening, Mike

IMO you don't have CHS. But you might figure out that with your body the combustion might be related to or contributing to your symptomology. I think 100% vaping and observing is a reasonable approach. It would be nice to keep a doctor in the loop in case your symptoms are from treatable illness.

 

[chris 71]

My son just had his first attack after smoking a lot of DAB. .

its interesting you mention toxic canabinoids , as i have read that there are some canabiniods that are from the act of combustion , and dont exist without combustion . so you could be onto something here .

but above you mention your son seeming to come down with CHS after to much DAB . from what i know dabbing is not combustion but vaping . i wonder if there are any cases of CHS from strictly vaping or edibles as that would mean its not only from smoking .

i still think its not possible yet to call this a legitimate thing caused buy canabiniods them selfs . as there is just to many other things that could be the cause . im not saying it wont turn out to be . but show me the scientific evidence that point to a canabiniods or toxic canabiniods being the definite culprit id be interested in seeing that ,

 

[slozukimc]

IMO you don't have CHS. But you might figure out that with your body the combustion might be related to or contributing to your symptomology. I think 100% vaping and observing is a reasonable approach. It would be nice to keep a doctor in the loop in case your symptoms are from treatable illness.

I hope you are right. I think. I want this to stop so bad that I almost wish it could be as simple as stopping weed. It takes every bit of willpower I have to wake up and go about the morning. I am sitting now sipping my coffee, not too fast or I will vomit, waiting for a bit of relief from the vape so I can do my chores for the morning.
The first morning after no combustion and the amount of mucous I am coughing up is making the nausea even worse. I know this will get better in a few days and I really hope that the phlegm in the back of my throat from smoking all of the time is what is triggering the vomiting. Feels like a sinus allergy attack or a bad cold on just the left side right now. That is pretty much the daily routine.
I used to work in NYC driving some folks to the farmers markets so I could not bring weed along with me. I got into vaping oils as a substitute to keep my nerves calm around the thousands of strangers and keep from feeling like death from the nausea. It seems almost like withdrawal symptoms if I don't vape. That job was very stressful and I was sick during that time more than I ever have been. I mentioned before that I had been hospitalized twice in two years for flu like symptoms. There were many other times that I just refused to go to the hospital and suffered it out on the couch. Another that I spent the entire day in the Pret A Manger restroom before attempting to ride 4 hours back home. Had to stop several times on that trip and I literally felt like death would be better. I am NOT a negative minded person. I try to look for joy in even the smallest things but when this comes on in force it just makes me feel like quitting. I won't quit of course. That would be the cowardly way out. I will either figure out a solution or die an old man trying.
I don't mean to ramble and I hope I am not imposing as I see here that most of you folks have way worse problems than I do. It is just nice to chat with folks who can relate and not judge. If I say anything about the possibility of CHS to anyone I know they either turn away with disinterest or defend the weed with full force and say I am an idiot. I don't know what makes me feel like this shit every day and apparently neither does my Doc. I have had every test and scan done that he can think of and nothing. I am frustrated with even speaking to him about it as he is beginning to act like he thinks I am after drugs even though I specifically try to find any natural remedy before using pharmaceutical drugs. I smoke some weed, it helps me a lot and I enjoy it so I must be a druggie right? I am so damned sick of that ass backwards logic!

Thanks for listening and best wishes and better health to everyone here, Mike

 

[chris 71]

i have posted in this thread a few times , not to defend the weed but because i was starting to wonder if this was possibly what was wrong with me .

i have been very sick for a few years luckily i went to see another doc then my regular one . because he was telling me there was nothing wrong with me for years lol .
whats worse is that when i did get to a walk in clinic and the doc there ordered some test and came back with some red flags for a thyroid disease . i went with the results to my reg doc and he told me that it was normal lol

anyway thankfully the clinic doc referred me to an endo doc who ordered more test turns out i have graves disease and am now taking meds ive gained 10 pounds and feel much better although the meds make me feel sick as a side effect .

as far as what i have said about not knowing how they can be sure if cannabiniods are the problem causing CHS . i still think there are just to many other possibilities arent there ? and even if it is caused by " cannabis "
do they know for sure it is a toxicity to " THC " as they would have you believe or is there more to it then that . are there actual studies and evidence showing it ? untill then it could very well be any number of things .
and why only some seem to be effected . i do find it interesting and to prove im not just being a defender of the weed i have even questioned if it could have been the cannabis causing me graves disease . doc say he doesnt think so but who knows

 

[slozukimc]

Just returned from worshipping the porcelain god. The acid levels in my stomach today are crazy! Feels like throwing up battery acid. Ate some toast earlier and that didn't help settle anything. The vape doesn't seem to be helping the nausea at all at this point. Almost ready to try a bong and go lay down. If I can get control of this acid problem I think I can get through the nausea and continue to quit combustion. Got a feeling this is gonna be a long and rough road.

Has anyone here had experience with poorly purged oils causing or exacerbating heartburn? Just a thought.

Edit: So I gave in and smoked one small bong of a strain called thc bomb. The nausea is almost gone after only a couple minutes. The acid is still there but I can handle it now. The oil vape wasn't doing a thing for me so I am guessing that the relief I feel may be strain dependent. Maybe I can moderate my combustion and taper off to just vaping? Maybe I should try Da Buddha and lay off the oil? Not really sure but man am I glad I took that toke. I am feeling like I can function now. I can at least throw my coat on and walk our dogs and get some fresh air now.

Mike

 

[chris 71]

cannabis can slow down the digestion process and smoking will cause acid more then vaping in my experience . i have noticed this my self for sure .

these two things combined ( the smoke and slowing effects of digestion ) could defiantly aggravate your issues more then help
my self personally i find that a nice walk or exercise of some sort can help get things moving along

 

[slozukimc]

cannabis can slow down the digestion process and smoking will cause acid more then vaping in my experience . i have noticed this my self for sure .

these two things combined ( the smoke and slowing effects of digestion ) could defiantly aggravate your issues more then help
my self personally i find that a nice walk or exercise of some sort can help get things moving along

@chris 71 thanks for the tips. I agree that the smoke causes acid for sure. Cigs were even worse, probably because of the volume of smoke compared to weed. I know I have screwed up somehow and now it is up to me to fix it. I know that no matter what the studies say or don't say that any substance can be bad for you if you abuse it. I have some bad eating habits to fix that have come about simply because so don't feel like eating until I am queasy and weak. I have some serious weed consumption to curb. I have listened to everyone here and it seems my consumption is way higher than most. All day, every day. Wake in the night to hit the bong to feel better and sleep. A gram a day of very potent weed would be a very conservative estimate. That is too much and it is probably the root of my digestive issues. So. I probably don't have CHS. I probably just smoke too damned much, that screws up my digestion, the smoke gives me heartburn, the heartburn and phlegm from all of it causes the nausea. Still speculation. I will figure it out thanks to all of you folks listening. If my Doc would listen and not get all uncomfortable at even the mention of weed this might have been solved years ago. Guess I need to look for a new Doctor and I hate that idea.

Thanks again folks!

Mike

 

[chris 71]

good luck mike , try and stick to the vapor . its defiantly better for us daily users and after about a month of strictly vaping it starts to get better and easier

 

[Glass004]

Everybody is different. Even if you dont have the classic CHS, there is a possibility that the weed combustion is contributing to your GI symptoms.
Cannabinoids are fat soluble chemicals and with chronic smoking, a large amount gets in your fat tissues and hangs out for weeks in significant levels. It will take a few days for the positive effects of combustion abstention to occur.

For acid stomachs, PPIs (proton pump inhibitors) are tops, bananas are good in a pinch. Rebound acid can occur with Calcium antacids. Don't eat late at night? Elevate the head of your bed so that the acid drains out of your esophagus while you are lying down sleeping. Sleep on right side if possible. Keep antacid tablets by bedside, do not wait until the morning to take them as your esophagus is being burned. No fried foods, .......and don't call me mom :-)

its interesting you mention toxic canabinoids , as i have read that there are some canabiniods that are from the act of combustion , and dont exist without combustion . so you could be onto something here .

but above you mention your son seeming to come down with CHS after to much DAB . from what i know dabbing is not combustion but vaping . i wonder if there are any cases of CHS from strictly vaping or edibles as that would mean its not only from smoking .

i still think its not possible yet to call this a legitimate thing caused buy canabiniods them selfs . as there is just to many other things that could be the cause . im not saying it wont turn out to be . but show me the scientific evidence that point to a canabiniods or toxic canabiniods being the definite culprit id be interested in seeing that ,

About the DAB and combustion .....It is all about the method of administration used. They were taking a blow torch and heating up a metal spike to red hot. Then they inhaled the DAB vapors off of the spike when applied to the spike. In this manner the temps involved were way above combustion threshold.
I wish there was data about the toxic cannabinoids. This is only theory I thought of 5 years ago. I do have enough clinical and medical experience and research abilities to chase something like this down. Every thought current in the lit about CHS I had pegged 5 years ago. Research is hindered by archaic laws. It will be a while for the hard data to come out. I still haven't found any "hot shower turns off my symptoms" CHS people who vaped exclusively. Such people are only involved with combustion. The hot shower issue is the clue to the hypothalamus involvement for me. It is loaded with cannabinoid receptors. I put out the links on this forum a while back. I'm not motivated to chase them down or argue points as I am cured and feel if I tell someone the truth and they don't believe me, then their suffering is on them. Let them read through this and find it or they believe me. I have no skin in the game anymore.
Just a story. 15 years I had CHS. While I was working. I didn't want to admit being chronic as I was a professional. I laugh at my folly now, but for the longest time I did research trying to prove that the cannabinoids were not the cause of CHS as the first reports in New Zealand indicated. Scared the shit out of me as my secret was going to be found out if the docs I was complaining to about CHS got wise. I sure as heck did not want to stop using herb. Switching to vaping because of health and taste for two years, and restarting combustion as the vaporizers broke cycled me on and off combustion. These switch overs gave me a clue as symptoms followed use of combustion.

 

[Blackfriars]

I get random, lightish stomach pains since I have started vaping. They go away as soon as I vape again. I haven't worried about it much; and I certainly have never thrown up due to vaping too much. What a waste!

I now vape quite a bit (multiple times a day; weekends = all day), so that should tell you how much my random stomach pains have really bothered me. ;-)

Most strains I vape are very high in THC.

 

[CarolKing]

I used to use such things as Pepcid everyday for 3 or 4 years. I got nervous about what studies have said about these types of drugs. I decided to look for a natural alternative. Maybe this wouldn't work for all folks if they can't stomach using Cider Vinegar.

I found this remedy online and it works! I put approx a tablespoon of vinegar in a glass of water. I also can stand just using a tablespoon and drinking water after. I haven't had to use an antacid in 6 months or more. I do this every day or every other day. A very healthy alternative.

 

[Blackfriars]

I used to use such things as Pepcid everyday for 3 or 4 years. I got nervous about what studies have said about these types of drugs.

I used to take a Prevacid every day but I have lost a ton of weight - and thus no longer eat like I used to. No more Prevacid! I am glad too... The things were expensive as hell early on and I now know prolonged use of proton-pump inhibitors isn't well studied. Just not good to take untested things forever... IMO.

Thanks.

 

[slozukimc]

An interesting turn of events. I may have Lyme Disease. I have all of the symptoms and I live where there is a Lyme problem. I have a Docs appt on Monday. A close friend is on his way here with more info as his girlfriend has been fighting this for some time now. Will update as I know more.

Mike

 

[psychonaut]

I've heard that Tumeric is a nice natural remedy for GI issues. Also Anti-Inflamatory and Antioxidant. A study back in 2007 said that about 1/2 tsp of tumeric powder (approx 500mg of curcuminoids) daily is an appropriate dose.

 

[chris 71]

" An interesting turn of events. I may have Lyme Disease. I have all of the symptoms and I live where there is a Lyme problem. I have a Docs appt on Monday. A close friend is on his way here with more info as his girlfriend has been fighting this for some time now. Will update as I know more. "

Mike


hey mike , make sure you check into the different types of lyme disease test . as i remember reading that you have to make sure you get right test , as there is a couple different types of test or strains of lyme or something along those lines and it may not show unless you get the right test

 

[slozukimc]

" An interesting turn of events. I may have Lyme Disease. I have all of the symptoms and I live where there is a Lyme problem. I have a Docs appt on Monday. A close friend is on his way here with more info as his girlfriend has been fighting this for some time now. Will update as I know more. "

Mike


hey mike , make sure you check into the different types of lyme disease test . as i remember reading that you have to make sure you get right test , as there is a couple different types of test or strains of lyme or something along those lines and it may not show unless you get the right test

@chris 71 thank you! I am currently reading "Why Can't I get better?: solving the mystery of Lyme and chronic disease" by Richard I. Horowitz, MD.

The two test are ELISA and a Western blot. Apparently the latter is the more reliable test that insurance companies don't like to pay for.

Mike

 

[nickdanger]

@chris 71 thank you! I am currently reading "Why Can't I get better?: solving the mystery of Lyme and chronic disease" by Richard I. Horowitz, MD.

The two test are ELISA and a Western blot. Apparently the latter is the more reliable test that insurance companies don't like to pay for.

Mike

The best and most comprehensive Lyme and co-infection tests are done by Igenex Lab in California. Hopefully you can get your doctor to send your blood draw there, although they do not do insurance. Most regular insurance-approved labs don't test for enough "bands" and are notorious for false negatives, resulting in continued suffering. Luckily (?) you live where Lyme is recognized as a problem, so you have a better chance of being correctly diagnosed. Doctors where I live don't acknowledge that Lyme is a problem, but I've had it for 20+ years, now symptom free due to alternative treatments. It's a lot more pervasive than reported, and symptoms vary from person to person, and from one time to another. Very frustrating.

 

[slozukimc]

The best and most comprehensive Lyme and co-infection tests are done by Igenex Lab in California. Hopefully you can get your doctor to send your blood draw there, although they do not do insurance. Most regular insurance-approved labs don't test for enough "bands" and are notorious for false negatives, resulting in continued suffering. Luckily (?) you live where Lyme is recognized as a problem, so you have a better chance of being correctly diagnosed. Doctors where I live don't acknowledge that Lyme is a problem, but I've had it for 20+ years, now symptom free due to alternative treatments. It's a lot more pervasive than reported, and symptoms vary from person to person, and from one time to another. Very frustrating.

Would you care to share what those alternative treatments are? My friend has suggested Japanese Knot Weed.

Thank you, Mike

 

[nickdanger]

It has been quite a few years ago, so some of the newer herbals weren't known back then. There is a product called "Samento" which is TOA-free cats claw that was very helpful. Also, magnesium supplements are very helpful, along with others. You can also search for Lyme and alternative treatments to find more that I am not aware of. You need to be careful not to overdo treatments due to an effect called the Herxheimer (herx) reaction, which is common when killing pathogens.

I never realized when I was diagnosed with this, that the rabbit hole was so deep regarding Lyme. Conspiracy theories, doctors refusing to acknowledge/treat, etc. It is definitely not something 10 days of antibiotics will cure. There are various co-infections that occur with Lyme that can cause worse symptoms than the Lyme itself, so those have to be cleared up at the same time. Some of this is believed to be bioengineered. Check out the book "Lab 257".

What I primarily use now when my symptoms recur is Rife (frequency) therapy. If you do a search for Lyme and Rife you will get more information than you ever wanted to know.

 

[Chocolate Haze]

After experiencing similar symptoms to some of the reports on this thread, i figured i also suffered from the syndrome. However, after looking into what might has caused the morning vomits it's quite evident that it was a direct result of bad diet and nutrition. I go through 1-2g of herb a day depending on how busy i am with uni work, most of it vaped however still roll the occasional spliff with friends.

Consuming herb throughout the day combined with increased mental activity and me going to the gym daily accumulated to a Massive increase in my metabolism, to the point where if i didn't eat an hour prior to bedtime i would wake up in the middle of the night starving as fuck. So i started eating more fruits and vegetables during the day and treated myself to a high protein/low carb snack before bedtime and having a proper breakfast BEFORE turning on my Mighty...Well after 6 months of not having a single incident of vomiting in the morning, I would recommend taking a look at your diet & calorific intake before concluding that you suffer from CHS.

 

[Garysfriend]

I posted in this thread in April and November of 2016, believing I was having the early symptoms of CHS (two separate episodes). Long story short, it also appeared to be diet for me. I made some drastic changes in what/how I ate and the severe nausea and stomach pain went away. What's weird was that cannabis seemed to magnify the issue. Example, if I ate like crap, but didn't vape, I wouldn't usually have issues. If I did vape, and ate like crap I'd have issues. If I eat right, and try to do some exercise, and vape, I have no issues.

One thing I noticed cannabis seemed to reduce stomach acid (which can actually cause GERD like symptoms), so taking HCL pills with meals really helped.

Anyway, I just wanted to come back with an update, as I did not want to contribute to the paranoia. Not saying this isn't real, but I don't believe I have it. As Chocolate Haze said above, I think some people who think they have this (as I am guilty of) should take a look at what they eat first.

 

[slozukimc]

I posted in this thread in April and November of 2016, believing I was having the early symptoms of CHS (two separate episodes). Long story short, it also appeared to be diet for me. I made some drastic changes in what/how I ate and the severe nausea and stomach pain went away. What's weird was that cannabis seemed to magnify the issue. Example, if I ate like crap, but didn't vape, I wouldn't usually have issues. If I did vape, and ate like crap I'd have issues. If I eat right, and try to do some exercise, and vape, I have no issues.

One thing I noticed cannabis seemed to reduce stomach acid (which can actually cause GERD like symptoms), so taking HCL pills with meals really helped.

Anyway, I just wanted to come back with an update, as I did not want to contribute to the paranoia. Not saying this isn't real, but I don't believe I have it. As Chocolate Haze said above, I think some people who think they have this (as I am guilty of) should take a look at what they eat first.

I am doing that as well. I do not eat very well and that needs to change.

Mike

 

[Jimmy1018]

My doctor just concluded I have CHS. After 2 agonizing weeks of nausea, vommiting and body weakness (from not being able to eat or drink much) It all made sense. I was lucky to have an hour or 2 of relief each day from the nausea, it was seriously unbearable and I went to the ER 4 times in 12 days... I was taking between 4-8 baths a day with the occasional trip to my grandparents hotub. I was prescribed zofran and promethasine hydrochloride suppositories which did NOTHING. After all my blood tests and stool samples came back negative my doctor said it could only be CHS. It's been 1 week since I completely stopped smoking. Keep in mind I smoke out of glass and vapes everyday for the past 10 years. After 1 week of not smoking, my nausea is slowly ridding itself and gets better every day. My appetite is back (which I respect much more with healthier foods and smaller portions) and my body feels much stronger. For over a week all I could keep down was Ensure and water... I lost 17 pounds in 13 days (not good.) All I can say is if you really want to get better from CHS, you gotta stop smoking for a few weeks. I may or may not try making a comeback but I'd rather stop smoking forever than go through this hell caused by CHS. Hope this helps.

 

[slozukimc]

That nausea can be hell. Hope it feels better soon. Try just vaping instead of smoking. I cut way down on smoking and do more dabs and use my herb vapes and thankfully the only time I wake up feeling nauseous is when I have been around friends smoking.