While we hear about pot’s health benefits, we also know that smoking cigarettes poses health concerns. Is pot any different? Is there a healthiest way to smoke pot? While prohibition has kept scientific research from really exploring the different smoking methods, a few studies give us a little insight into what methods pose the least health risks, as well as best deliver the benefits pot has to offer. 

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Smoking Joints and Pipes 

The old-school methods of joints and pipes are still a popular way to smoke weed. Evidence is beginning to demonstrate positive results when it comes to smoking marijuana in comparison to cigarettes.  Regular marijuana smoking causes visible and microscopic injury to the airways and increases the risk of chronic bronchitis symptoms, though they subside after smoking cessation. According to Dr. Don Tashkin, MD of UCLA,  a leading cannabis researcher and a pulmonologist who has spent years studying the effects of cannabis on pulmonary function, reporting in the Annals of the American Thoracic Society (2013) stated that “the accumulated weight of evidence implies far lower risks for pulmonary complications of even regular heavy use of marijuana compared with the grave pulmonary consequences of tobacco.”  While carcinogens and cocarcinogens are present in marijuana smoke, studies have not shown that these contribute to an increased risk of either lung or upper airway cancer.  Another 2012 study, showed that smoking marijuana may not be as detrimental to your lung health as cigarette smoking is. This study looked at the association between occasionally smoking (cigarettes or marijuana) and pulmonary function over a 20-year period. The study measured forced expiratory volume in the first second of expiration (FEV1) and forced vital capacity (FVC). FEV measures how much air a person exhales when performing a forced breath and FEV1 is the first measurement in a typical series of three breaths. FVC measures the total amount of air that is exhaled during a complete FEV test.  While this study showed that cigarette smoking reduced FEV1 and FVC, marijuana use actually showed higher numbers. They rated marijuana smokers by joint-years, which equaled one joint or filled pipe bowl a day for a year. In users with over 7 joint-years throughout their life, the research found no evidence that marijuana adversely affects pulmonary function.

risks from smoking cigarettes by the CDC Source: CDC.gov
A literature review in 2016 showed similar results to the 2012 study, and while the cause of this difference is unclear, researchers believe that the acute bronchodilator and anti-inflammatory effects from marijuana may contribute to increased lung function.  Research is still in its infancy when it comes to marijuana because of its status as a controlled substance under federal law. Current knowledge shows that traditional pot-smoking methods are not as harmful as cigarette smoking to the lungs, and, in some ways, provide an increase in lung function. 

Vaporizers Offer Another Alternative

Vaporizers offer a pot-smoking alternative that works a little differently. Instead of burning, which causes smoke and tar, vaporizers heat the marijuana in order to release the active ingredients, such as THC. Studies show, traditional pot smoking doesn’t appear to increase lung damage risk and some studies do show benefits to vaping.  For example in a large internet study in 2007 comprising 6,883 people researchers at the University of Southern California and the State University of New York, Albany, found that the use of a vaporizer as a means of delivery, “predicted fewer respiratory symptoms even when age, sex, cigarette smoking, and amount of Cannabis used for taking into account.”  It should be noted that this internet study is self-reported-- leaving the results impacted by the placebo effect and biases. A 2004 study compared vapors from pot heated in a vaporizer versus the smoke produced from burning marijuana. The vapors from the vaporizer were a majority of THC while the burning smoke contained over 100 chemicals, including carcinogenic toxins. By using a vaporizer, you are reducing your potential risk from these carcinogens. Though, as studies have shown, there is no evidence at this point that the carcinogens present in marijuana smoke contribute to any serious medical risk.

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A word of caution regarding vaporizers

Vaporizers, however, do come with a different caution and researchers do not recommend those new to marijuana start with vaping. The reason being is vaping delivers much more direct THC than traditional smoking. A 2018 trial compared smoking and vaping and how it influenced drug effects and cognitive and psychomotor performance. 

Storz & Bickel Volcano Source: Wikileaf
In the trial, 17 healthy adults who infrequently used cannabis inhaled both smoked cannabis and vaporized cannabis containing 10 mg of THC. The second run had them inhaling 25 mg of THC. In terms of drug effect during the 10 mg phase, those smoking scored 46 while those vaping were higher at 69. With the 25 mg dose, the smoking results showed 66 while vaping scored 78.  The researchers concluded that vaporized cannabis resulted in stronger drug effects and significantly higher THC concentrations in the blood. 

No Clear Answer on Which Method is Really Better

If you are concerned about possible carcinogens when it comes to smoking in any form, there are always edibles. But they come with considerations as well. According to an observational study in 2019, edible cannabis is more likely to cause emergency room visits. This study looked at 9,973 emergency room visits in a Colorado hospital between January 2012 and December 2016. Patients with symptoms related to both cannabis smoking and edibles were included. Inhalation cases were more often related to cannabinoid hyperemesis syndrome, that leads to vomiting. It is rare and typically only occurs in daily long-term users. In fact daily marijuana use is characteristic and often reported as exceeding three to five times per day. On the other hand, edible connected cases were due to acute psychiatric symptoms, intoxication, and cardiovascular symptoms. With recent legalization or marijuana in many states, research into the effects of the drug are likely to increase and may help paint a better picture. Until that occurs, the best method for smoking pot is what works best for you. 

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