Smoking Vs Vaping Weed: Are they really all that different?

Electronic vaporization of cannabis was supposed to be the safer alternative to smoking. After all, users still get all the benefits of the cannabinoids and terpenes without inhaling combusted products like carbon monoxide, plant matter particulates, or the over 100 toxins that are released when flower is burned.

However, a few years ago, an outbreak lung illness, most of which were tied to the vaporization of illegal THC-containing oils, challenged this illusion of safety. Vitamin E acetate, a cheap thickening additive for diluting oils was deemed the culprit and quickly removed from products, yet its prevalence may persist in illicit oils and vape pens.

Even though the rates of these electronic vaporization associated lung illnesses (EVALIs) have been falling drastically since their peak in September 2019, safety concerns around cannabis vaporization are still present in peer reviewed scientific reports and in popular media sources. While much has been written about the pros and cons of vaping compared to smoking cannabis, it’s important to re-address the topic in the post-vitamin E acetate era to draw comparisons.

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Why vape cannabis?

The increased popularity of vaping cannabis is believed to be tied to legal access. Yet vaping is rarely the sole mode of cannabis consumption: 13% who vape cannabis only vape. People often choose to vape cannabis over smoking flower because of its convenience, discretion, and efficiency; there are times when one just doesn’t want their space to smell like weed.

Vaping is also deemed to be the safer option since heating the liquid rarely surpasses 400°F, whereas combusting flower approaches 500°F, thereby reducing the amount of harmful gases and toxins that are inhaled.

Furthermore, for those seeking specific and repeatable effects, the cannabinoid (e.g., THC or CBD) and terpene composition of vape carts can be consistently reproduced.

Also, the oils can be optimized for a particular therapeutic need or recreational desire through the addition of cannabinoids and terpenes at levels that are impossible to achieve with traditional grow methods and the limitations of a strain’s genetics. Notably, the science behind what represents a therapeutically-optimized composition remains mostly theoretical.  

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Is vaping safer than smoking?

There aren’t any studies within the last couple years that directly compare the safety of smoking and vaping cannabis in a controlled and randomized manner (a standard methodological model for drawing causative conclusions).

Nonetheless, the perception that vaping doesn’t harm the lungs is likely wrong. A 2020 study of 2,553 young adults found that cannabis vaping at any point was associated with increased risk for bronchitic symptoms, such as shortness of breath. This outcome persisted even after adjusting for nicotine vaping and smoking cannabis or tobacco.

Vaping at least 3 times in the last month doubled the risk for experiencing wheezing, which is a short whistle or rattle when one breathes due to a partially blocked airway. However, given the proximity to the vitamin E acetate era, it’s impossible to rule out impacts that possible previous exposure to vitamin E may have on the lungs.  

Studies of e-cigarettes have clearly demonstrated a link with adverse effects on the lungs and airway. But inflammation in the airway can be triggered by the vape liquid itself, even in the absence of nicotine, suggesting that some of these effects may carry over to vaporization of cannabinoids.

The anti-inflammatory properties of THC and CBD, especially in combination, may counter some of these inflammatory effects of vaporization, but irritation of the airway is commonly reported from vaporizing cannabis, suggesting that there will still be some inflammation.

Some additional health concerns may arise when consuming unregulated vape products. Although vitamin E acetate has largely disappeared from vape products, the same damaging gas that’s released from heating vitamin E acetate and led to the EVALI epidemic in 2019 can be produced by other compounds found in unregulated delta-8, CBN, and CBG vape products. Knowing what’s in your vape cart is essential for safe use.