Could there be a connection between alpha 1 antitrypsin deficiency and smoking marijuana?

Not sure: This is an interesting question as Alpha 1 antitrypsin deficiency is not "caused" by cigarette smoking, but can certainly be aggravated by it. Thus, i think it is safe to say that any smoking may aggravate the symptoms of Alpha 1, but i don't think that there is a direct connection as smoking marijuana does not have primary affect on the enzyme activity.