Smoking Weed vs Vaping: Are They Really That Different?

Electronic vaporization of cannabis should be the safer alternative to smoking. Finally, users still get all the benefits of the cannabinoids and terpenes without inhaling any burned products like carbon monoxide, plant matter particles, or the 100+ toxins released when buds are burned.

A few years ago, however, this illusion of safety was challenged by an outbreak of lung diseases, most of which were linked to vaping illegal THC-containing oils. Vitamin E acetate, a cheap thickening additive used to thin oils, was considered a culprit and was quickly removed from products, but its prevalence may remain in illegal oils and vape pens.

Although rates of these electronic vaporization-related lung diseases (EVALIs) have decreased dramatically since their peak in September 2019, safety concerns regarding cannabis vaporization remain in peer-reviewed scientific reports and popular media sources. While much has been written about the pros and cons of vaping versus smoking cannabis, it’s important to revisit the topic in the post-Vitamin E acetate era to draw comparisons.

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Why Vape Cannabis?

The increasing popularity of vaping cannabis is believed to be related to legal access. However, vaping is rarely the only form of cannabis use: 13% who vape cannabis only vape. People often choose to vape cannabis over smoking flower for convenience, discretion, and efficiency; There are times when you just don’t want your room to smell like weed.

Vaporizing is also considered the safer option as heating the liquid rarely exceeds 400°F while burning bud approaches 500°F, reducing the amount of noxious gases and toxins that are inhaled.

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

Additionally, the oils can be optimized for a specific therapeutic or recreational need by adding cannabinoids and terpenes in amounts that are impossible to achieve with traditional growing methods and the limitations of a strain’s genetics. In particular, the science behind what constitutes a therapeutically optimized composition remains largely theoretical.

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Is vaping safer than smoking?

In recent years, there have been no studies directly comparing the safety of smoking and vaping cannabis in a controlled and randomized manner (a standard methodological model for drawing causal inferences).

Still, the assumption that vaping doesn’t harm the lungs is probably wrong. A 2020 study of 2,553 young adults found that vaping cannabis was associated with an increased risk of bronchial symptoms, such as shortness of breath, at any point in time. This result persisted after adjusting for vaping nicotine and smoking cannabis or tobacco.

Vaping at least 3 times in the last month doubled the risk of wheezing, which is a short whistling or rattling noise when breathing from a partially blocked airway. However, given the proximity to the vitamin E acetate era, it is impossible to rule out effects that possible past exposure to vitamin E might have on the lungs.

Studies on e-cigarettes have clearly shown an association with adverse effects on the lungs and airways. But inflammation in the airways can be triggered by the vape liquid itself, even in the absence of nicotine, suggesting that some of these effects may be extrapolated to cannabinoid vaporization.

The anti-inflammatory properties of THC and CBD, especially when combined, may counteract some of these inflammatory effects of vaping, but respiratory irritation from vaping cannabis is often reported, suggesting that some inflammation will still be present .

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

Do vaping and smoking have different effects?

Results from studies comparing smoking and vaping cannabis show quite a bit of variability, highlighting the challenges of studying these routes of use in humans. For example, history and frequency of use, as well as natural patterns of puffing, vary widely from person to person and can affect how much cannabinoids enter the body and how long they stay.

In a study where the amount of inhalation was tightly regulated, there were no significant differences in THC or other cannabinoids collected in the blood between the two methods.

However, in a study of infrequent cannabis users (i.e. no use in the past 30 days), vaporization resulted in higher blood THC levels and greater impairment on several cognitive, visual and subjective measures compared to smoking.

Similarly, a separate study looked at how smoking affects appetite and metabolism-related hormones after eating a standard breakfast compared to vaping. While both smoking and vaping cannabis reduced insulin levels, smoking cannabis resulted in greater insulin reductions 15 minutes after use.

This reduction in insulin levels may partially explain the low rates of type II diabetes among regular cannabis users, a disease resulting from excessive insulin release that eventually leads to insulin resistance.

Which one is better? Smoking or vaping?

The EVALI scare of 2019 has tarnished the safety reputation of vape devices in the minds of the public, media, and research community. These accounts of the harm caused by cannabis vaporization can contribute to “white hat bias” — when people misrepresent information, often unintentionally, to fit societal expectations or personal feelings about an industry.

In this case, historical illegality and deep-rooted societal beliefs about the harmful effects of cannabis may have led to the assumption that vaping cannabis is just as harmful, if not worse, than smoking flowers.

Some may report that their subjective experiences are consistent with these beliefs, despite a lack of evidence pointing to increased harm from vaping. However, while most devices no longer contain the patently harmful additives that contributed to hospitalizations and deaths during the EVALI outbreak, illegal and unapproved devices and e-cigarette oils remain in circulation.

Studies comparing the long-term safety and health effects between smoking and vaping often capture a period of use when these unregulated products were more readily available, making it difficult to draw conclusions about the long-term safety of vaping with current devices and oils.

Acutely, there are no clear differences in the effects produced by smoking versus vaping, or in terms of cannabinoid levels in the body. But differences in draw patterns between smoking a bowl and vaping a vape pen can result in different effects on the brain and body. Ultimately, as with most cannabis products, knowledge of the content, reputation of the source, and regulation of use are the most important factors in safe and effective use.

Josh Kaplan

Josh Kaplan, Ph.D., is an assistant professor of behavioral neuroscience at Western Washington University. He is a passionate science writer, educator and runs a laboratory researching the developmental and therapeutic effects of cannabis.

Check out Josh Kaplan’s articles

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