When it comes to vaping, it seems like the negative reactions far outweigh the positive. The image has long sparked a certain discomfort on the part of the general public. And of course, in recent months the news of illnesses and deaths related to vaping has escaped few people, with the numbers tragically requiring updates on an almost daily basis. While it’s likely that most people associate vaping with nicotine, in fact between 15 and 30% of total adult-use cannabis sales are accounted for by vapor pens.[i]

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This figure has taken a hit since the accounts of serious health problems were first reported. Both the federal and some state governments are taking action against vaping. But whatever your reaction to this, in most of the discussions it seems that awareness of the facts about vaping-related health problems hasn’t always been in evidence.

Fact number one: most of the reported cases of EVALI, as the illness is now known, occurred after the patient vaped black market cannabis, rather than legal weed or nicotine. But you’d never know that to hear some reports. A recent poll in North Carolina found that 50% of registered voters supported a ban on e-cigarettes and vaping. One article reporting on the poll had this to say: “While some EVALI patients report using black-market marijuana oils or concentrates in e-cigarettes, many EVALI patients only used nicotine vape products, according to the CDC.”[ii]

Actually, while that’s technically accurate, the statement juxtaposes the words “some” and “many” to give the inaccurate impression that nicotine-related cases are more prevalent than those related to black-market marijuana. What the CDC actually said was that among 573 cases with information on the substance actually used, only “13% reported exclusive use of nicotine-containing products.”[iii]

The CDC also said that “The latest national and state findings suggest products containing THC, particularly those obtained off the street or from other informal sources (e.g., friends, family members, illicit dealers) are linked to most of the cases and play a major role in the outbreak.”[iv]

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Illicit Marijuana is Partially at Fault

I’m not taking a stand one way or the other on nicotine vaping; I’m only pointing out that in their zeal to condemn nicotine many people are glossing over the connection to illicit use of marijuana – perhaps because they’re reluctant to emphasize anything that contributes to the argument against legalization. And that’s exactly what these statistics do.

For another way to frame this: the numbers change almost daily, but as of this writing the CDC has issued reports on the number of vaping related lung injuries by state. (Actually, they haven’t issued precise numbers; merely an annotation for all 50 states plus D.C. that indicate which range each one falls into, e.g., which states have had 0-9 cases, which have had 10-49 cases, etc.)[v]

I took that data, converted it to injuries per 1,000,000 people (using the worst-case number for each state) and came up with Figure 1, which ranks the 25 states with the fewest vaping-related lung injuries per capita from 1-25.

States with fewest vaping-related incidents Source: Wikileaf
Of the ten states in which recreational cannabis is currently legal, eight are in the top 25 when it comes to the fewest vaping-related lung injuries. Five are in the top ten, and in fact, the three jurisdictions with the fewest injuries per capita are all legal weed states. The top two – Alaska and the District of Columbia – are the only jurisdictions that have yet to record a vaping-related lung injury as of this writing.

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The legalization of weed in a given state may well be a contributing factor to a reduced likelihood of health problems related to vaping. But what will happen to vaping as a means of using legal cannabis once the current medical situation is better understood? Will the current crisis create a lasting drag on sales, or will growth resume at some point?

Wikileaf's Projections for the Vaping Industry

Figure 2 graphs the weekly number of hospital admissions for vaping-related lung injuries (nationally) since early June and compares it to the share of the legal cannabis market accounted for by vaping for California, as just one example.[vi] (The market share data is currently available only through September.) People are presumably hearing of those reports and some, at least, are taking them to heart; shortly after the number of reports started increasing, the vaping share for California cannabis (and other markets) began declining.

Projections for cannabis vape pen sales Source: Wikileaf
But more recently those share declines have begun stabilizing, even as reports of hospitalizations began declining rapidly. I developed a statistical model correlating market share in a given week with hospitalizations two months prior (because, as the data analysis revealed, the news appears to take about two months to reach people and affect behavior). Then I projected the statistical relationship forward, with that projection also shown in Figure 2.

The model predicts a full recovery for market share within a month of the return to normal in terms of hospitalizations. Of course, statistical models are only as good as the assumptions they’re based on. This one won’t be a reasonable representation of reality unless people who took a break from vaping legal cannabis do in fact return to their former habits, and that won’t happen unless they feel confident that proper quality control and safety measures are in place. And legalization is once again the key. Quality control is not something anyone is likely to associate with black market marijuana, for good reason.

Still, I take pains to make it clear that some vaping-related injuries are in fact related to legal cannabis; in no way am I dismissing this connection. But the differing safety records associated with legal and illegal sourcing can’t be ignored. Not only is legalization the right thing to do for a whole host of established reasons, now it’s likely an important step in addressing a deadly health problem.