Vaporizers Are Not A Safe Way To Smoke Marijuana
Chris Vincent, MD, is a licensed physician, surgeon, and board-certified doctor of family medicine.
10/21/2019 UPDATE: Recent illnesses have been associated with use of e-cigarettes (vaping). Since the specific causes of these lung injury cases are not yet known, the Centers for Disease Control and Prevention (CDC) recommends refraining from all vaping products. Because THC products appear to be implicated in many if not most of these vaping-related lung injuries, nobody should consume marijuana products by vaping.
Most people (92.1%) who use marijuana in the United States reported using only a combusted form of marijuana like from a joint or bowl, but that could be changing. Vaping cannabis products is more popular among teens and young adults, and trends show vaping overall is climbing fast in that population — in part, because many think it’s a healthier alternative to smoking.
Vaping weed, as opposed to smoking it, exposes you to fewer of the toxic compounds that come from burning cannabis. But there are still significant risks from vaping, including exposing the body to harmful ingredients and potentially increasing your chances of lung damage. Here’s what we know about the possible health impacts of vaping weed.
What Is a Vaporizer?
Before diving into the health effects of vaping, it can be helpful to first understand what it means to vaporize weed as opposed to smoking it.
If you’ve seen an e-cigarette device like JUUL, you’ve seen a vaporizer. Unlike traditional cigarettes that burn leaves to make smoke, these devices use batteries and small metal coils to heat up a liquid and create a vapor-like aerosol —which is why these devices are referred to as “vaporizers” and using them is often called “vaping.”
People vape a wide range of things, including nicotine, flavorings, and cannabis products like THC and CBD made from flower or concentrate.
Why Do People Think Vaping Marijuana Is Safer?
Smoking anything — be it tobacco or marijuana leaves — is inarguably dangerous to your health. When you smoke, you inhale very hot pieces of debris that irritate the sensitive tissue in your lungs, which is why heavy marijuana smokers are more likely than nonsmokers to have respiratory issues like chronic bronchitis . Burning leaves can also cause chemical reactions that lead you to inhale potentially toxic compounds, some of which are linked to cancer.
In contrast, vaporizers don’t burn anything. They heat up cannabis-containing fluids until they’re hot enough to create an aerosol — but not so hot that they combust. Compared to the hot, harsh smoke produced by burning leaves, the aerosol made by vaporizers feels a lot easier on the lungs. One small study, for example, found that cannabis users with breathing problems were able to recover some of their lung function after making the switch to vaping.
What Are the Risks of Vaping Marijuana?
While vaping weed might seem like a less harmful alternative to smoking it, it’s not entirely harmless. In addition to the health risks associated with THC — the psychoactive chemical in cannabis — vaping itself can be potentially damaging to a person’s health.
Potentially Harmful Ingredients
When you vape weed, it’s not the only thing you’re inhaling. Vape fluids use a wide range of ingredients to suspend THC or CBD, create a vapor-like aerosol, or add flavor — all of which can irritate the delicate tissues and air sacs in the lungs.
Part of the issue with vaping cartridges is that they haven’t been as tightly regulated as other products. Ingredients lists aren’t always complete, and people sometimes don’t know what’s inside the vaping fluids. Because there’s so much variation among vaping products, it’s difficult to say exactly what is in any one pod or device.
- Heavy metals: Vape pens themselves can cause small amounts of heavy metals or other debris to get into the aerosol you inhale, too. The tiny coils often used to heat up vaping fluid are made using a wide variety of metals that can get weakened and break down over time.
- Carcinogenic compounds: Some of the chemicals used to suspend THC or make a “vapor” can also release potentially dangerous, cancer-causing compounds when they’re heated up.
- Ultrafine particulates: Because vaporizers don’t burn leaves, they don’t have as many of the tiny pieces of debris that are found in combusted products like pipes or cigarettes. But studies show that vaping fluids can still contain some extremely tiny particulates that, when inhaled, get deep into the lungs and cause irritation.
- Flavorants: Added flavors have become popular with e-cigarettes, especially among teens and young adults, and they’re also sometimes added to vaping products with cannabis compounds. Some of the chemicals used to flavor vape fluids like diacetyl have been linked to serious lung issues when inhaled. As of Feb. 1, 2020, the U.S. Food and Drug Administration bans the manufacture and sale of flavored vaping products (excluding menthol and tobacco).
For its part, the U.S. Food and Drug Administration has started to rein in vaping companies by sending warning letters to manufacturers who market their products using false or misleading claims about their contents. Even so, vape pen users can still purchase bootleg versions of products online or even make their own at home — neither of which are guaranteed to be tested for safety.
Higher Doses of THC
A small study published in 2018 looked at whether using a vaporizer or traditional pipe changed how weed affected the body. In it, the researchers found that inhaling vaporized cannabis resulted in participants having higher concentrations of THC in the bloodstream and more psychoactive effects than when they smoked it in a traditional pipe — even though the cannabis doses were carefully controlled to be the same at the outset.
Vaping THC and Lung Injury
In 2019, cases of severe lung disease linked to vaping started popping up throughout the United States. By November, more than 2,290 cases of the condition — dubbed e-cigarette, or vaping, product use associated lung injury (EVALI) — were reported in every state but Alaska, and at least 47 people had died. Public health officials still aren’t sure what’s behind the outbreak, but everyone who got sick reported a history of vaping, and most reported using vaping products that contained THC.
The cases weren’t initially easy to spot, in part because they look a lot like other respiratory conditions, including the flu. The symptoms of EVALI include:
- Shortness of breath
- Chest pain
- Gastrointestinal issues like nausea, vomiting, or diarrhea
- Weight Loss
- Abdominal pain
The bulk of the cases were linked to bootleg products containing THC, such as those bought from informal sources or illicit dealers online, prompting the CDC to flag them as a major player in the outbreak.
Health officials still aren’t certain what specific compound or ingredient is causing the lung damage, but there is some suggestion vitamin E acetate may be a culprit. As a result, the CDC issued a recommendation that people avoid using vaping products that contain THC, especially one that was purchased off the street or that have been modified or used in a way other than intended by the manufacturer.
A Word From Verywell
Vaping marijuana might expose you to fewer toxic ingredients than smoking it, but it’s far from harmless. A lot more research is needed to fully understand the health risks associated with vaping in general and vaping marijuana and its related compounds specifically.
If you or someone you know has a marijuana or other substance use disorder, talk to your doctor about evidence-based treatment options, or call SAMHSA’s National Helpline at 1-800-662-HELP (4357) or TTY: 1-800-487-4889. You can also get help by using SAMHSA’s Behavioral Health Treatment Services Locator.
While vaporizing weed might expose you to fewer cancer-causing substances, there are some potentially serious risks to vaping.
What’s the Safest Way to Consume Cannabis Right Now?
Even in the face of the new coronavirus, people need their weed. In fact, cannabis dispensaries are considered an “essential” business in several states and are still selling cannabis, often prioritizing medical cannabis patients.
But, considering that both inhaling cannabis and the new coronavirus can take a toll on your lungs, you might be wondering whether it’s safe to smoke weed right now. The truth is that everyone is different and, with so little research, it’s hard to know what might be right or wrong in any individual case. So SELF spoke to a few experts to learn as much as we could.
Smoking anything—including cannabis—should not be your first choice right now.
The first thing to know is that “we don’t have a lot of data,” Kathryn Melamed, M.D., pulmonary and critical care physician at Ronald Reagan UCLA Medical Center, tells SELF. “This is all very new and we’re learning as we go.”
So we don’t have any research specifically on how the new coronavirus might affect those who regularly smoke cannabis. But we can get some clues from early research on those who developed COVID-19 and smoked cigarettes, Jordan Tishler, M.D., medical cannabis expert at InhaleMD in Boston, tells SELF.
For instance, in a meta-analysis published last month in the Archives of Academic Emergency Medicine, researchers pooled data from previous studies that contained information on nearly 77,000 patients. They found that smoking cigarettes was one of a few underlying health conditions found frequently in coronavirus patients along with high blood pressure, heart disease, chronic obstructive pulmonary disorder, diabetes, and kidney disease. And both the CDC and WHO list smokers as being high-risk for severe symptoms from a COVID-19 infection.
That’s not totally surprising because the effects of smoking on the lungs are well-established. We know that smoking does damage to the elastic tissues of the lungs, which affects their ability to actually ventilate and allow you to breathe, Dr. Melamed explains. It also causes damage to the cilia, the little hairlike projections that line and help clean the lungs, which makes it harder for them to get rid of particles you breathe in normally that can cause further issues.
In the long-term, that kind of damage leads to COPD and related issues, like emphysema and chronic bronchitis, and also predisposes you to developing infections like pneumonia, Dr. Melamed says.
And even in the short-term, “you could imagine that if smoking cigarettes or marijuana was leading to any sort of lung damage or predisposing you to lung injury, that would put you at some increased risk of poor outcomes if infected with coronavirus,” Dr. Melamed says. But, again, our understanding of how this might affect your risk for severe COVID-19 symptoms is still developing.
So how does smoking cigarettes compare with smoking cannabis? “Generally speaking, we do not see the same pattern of lung disease in patients who only smoke cannabis compared to tobacco,” Dr. Melamed says. Part of that may be due to the difference in the amount of smoking that occurs in those two groups, as well as the amount of carcinogenic compounds found in cigarettes. Overall, there isn’t a lot of data, but the evidence we have so far suggests that smoking cannabis poses much less of a risk to your health, SELF explained previously.
But if you have the option to consume cannabis without smoking it, you should probably take it, Dr. Tishler says. Even if there’s minimal risk to your long-term health associated with smoking cannabis, just the simple act of smoking can cause lung irritation, wheezing, and coughing. And if you have asthma or any chronic lung disease, you might find that smoking weed aggravates or triggers your symptoms.
Those are unpleasant effects at any point, but especially now that we are in the middle of the new coronavirus pandemic. Considering that COVID-19 infection comes with respiratory symptoms, including a cough, you might want to avoid doing anything that can similarly contribute to respiratory issues—even if only to avoid the anxiety that would come with experiencing those symptoms.
Ultimately, even though we know smoking cigarettes and smoking cannabis are different in some important ways, Dr. Tishler says that if you can avoid smoking anything—including cannabis—you probably should.
What should you do if you don’t want to smoke?
Smoking cannabis shouldn’t be your first choice, experts say. But some people rely on cannabis to help manage medical conditions. Is smoking okay in those situations? “It’s all about risk and benefit here,” Dr. Melamed says, adding that effectively managing any chronic medical conditions you have is also key in preventing severe infection from the coronavirus, which may include using cannabis. She recommends limiting your consumption to only the amount that’s actually necessary and that, ultimately, the decision to smoke or not should be made with the help of the medical professional who is recommending your cannabis use.
If you have the option to do something other than smoke your cannabis, here are some alternatives that would be less likely to irritate your lungs:
Vaping (but not from cartridges): Using a vaporizer is probably the closest thing to smoking that you can do without actually smoking. Vaporizers heat the weed enough to release the compounds you want (like THC and CBD) but not enough to actually burn it and produce those pyrolytic compounds. So this is generally considered to be a safer way to inhale cannabis than smoking. Vaping is ideal for patients who need fast relief from their symptoms, Dr. Tishler says, because its effects are felt within 10 to 15 minutes and don’t last as long as those felt with edibles.
But, as SELF explained previously, experts recommend sticking to vaporizers that use dry herb (actual cannabis plant material) rather than vapes that heat concentrated cartridges of oil. Vape cartridges were recently linked to an outbreak of serious lung illnesses, and we don’t know very much about how even legal vape pens like these affect the lungs, Dr. Melamed says, noting that she has “a lot of concerns about the long-term health risks of vaping” these products. She recommended that people avoid using vape pens like these and cautioned that any new device that isn’t FDA-approved—including dry herbs vapes—may have long-term risks we aren’t aware of yet.
Edibles: These are products designed to be eaten, and they come in a variety of forms. You’ll see them as the classic gummies, brownies, and cookies as well as drinks, pills, capsules, and tinctures, which are cannabis-infused liquids made from oil or alcohol that can be taken alone or mixed into food or drinks. Edibles may be better for people who are managing more chronic health issues (like chronic pain) because, although they don’t begin to work as quickly as inhaled cannabis, the effects last longer, Dr. Tishler explains.
However, there are some drawbacks to this method, including the fact that the cannabis you’re eating has to go through your digestive system before getting to your bloodstream. That means it will take longer—anywhere between 30 minutes and two hours—before you’ll experience the effects. And the effects you experience may feel different or stronger compared with those you had after smoking or vaping due to a different THC conversion process.
There are a bunch of other possible methods of administration, but Dr. Tishler says these are the ones we know the most about and, therefore, the ones he trusts and most regularly recommends to patients.
Whatever you decide to do, remember the golden rule: Start low and go slow, meaning that you should choose a low dose to start with and increase your dose very slowly. Only take more after you’ve given your first dose enough time to work. And remember that even medical cannabis products in a dispensary don’t go through the same rigorous FDA approval process that prescription medications do, Dr. Tishler says. So your experience with these products may be hard to predict.
And, of course, regardless of smoking, the most effective ways to avoid an infection are still maintaining social distancing, washing your hands, and wearing a mask, Dr. Melamed says. Above all, if you’re not sure what you should be doing right now, it’s important to check in with a medical professional who can take your unique personal circumstances into account.
Considering that the new coronavirus can cause serious respiratory symptoms, is it safe to smoke weed right now?