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Vaping, Smoking, or Eating Marijuana

The safety and long-term health effects of using e-cigarettes or other vaping products still aren’t well known. In September 2019, federal and state health authorities began investigating an outbreak of a severe lung disease associated with e-cigarettes and other vaping products . We’re closely monitoring the situation and will update our content as soon as more information is available.

Over the past decade, marijuana laws have continued to change across the United States.

What was once vilified as a potentially dangerous “gateway drug” is now being recognized by many states (33 plus Washington, D.C., to be exact) as having medicinal properties that can help manage a range of health conditions, from anxiety and cancer to chronic pain and more.

Marijuana is now also recreationally legal in 11 of those 33 states. (Note that marijuana is still classified as illegal by the U.S. federal government.)

In states where marijuana is legal, it’s being sold mostly in three different ways:

  • to be smoked
  • to be eaten
  • to be vaped

If you live in a state where marijuana is legal, you might be wondering how best to consume it, especially in light of recent federal investigations into the safety of vaping .

Here’s what we know.

For decades, health experts warned the public about the dangers of inhaling tobacco smoke from cigarettes, cigars, and pipes.

For marijuana, some research suggests some compounds in it, known as cannabinoids, may have a few benefits.

One of the more well-known cannabinoids is called CBD. For this reason, some people believe smoking marijuana is less dangerous than smoking tobacco.

Cannabinoids, such as CBD, are different from tetrahydrocannabinol (THC), the chemical in marijuana that gets a person “high.”

What about smoking?

Inhaling smoke of any kind — whether it’s cannabinoid-containing weed or tobacco or another substance — is bad for lung health, according to the American Lung Association.

Most marijuana users hold smoke in their lungs longer than tobacco smokers, putting them at greater risk for exposure to tar — which is harmful to the lungs.

Some negative health effects associated with chronic weed smoking include:

  • air pockets between the lungs and lungs and chest wall
  • chronic bronchitis
  • cough
  • excessive mucus production
  • possible increased risk of infection in immunocompromised people, such as those with HIV
  • possible increased risk of lower respiratory tract infections
  • weakened immune system
  • wheezing

What about vaping?

Vaping marijuana involves inhaling heated oil through a vaporizing device, often referred to as an e-cigarette. Vaping marijuana can also refer to using a vaporizer, such as a Volcano , to produce vapor from dried plant material.

Some people believe vaping is safer than smoking because it doesn’t involve inhaling smoke. But the reality is, when it comes to vaping marijuana, there’s much less known about the negative health effects.

The most recent research suggests vaping THC oil could be quite harmful to lung health. The greatest concern at the moment is the severe effects of inhaling vitamin E acetate. This additive chemical has been found in many vaping products that contain THC.

As of Dec. 27, 2019, nearly 2,561 cases of lung injury (EVALI) caused by inhalation of vitamin E acetate, or “popcorn lung,” have been reported in all 50 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands) and have led to 55 deaths during that time, according to the Centers for Disease Control and Prevention (CDC) .

Some of the people affected by vaping illnesses include children.

The CDC recommends people avoid using e-cigarettes and vaping products, particularly those containing THC oil, because they’re likely to contain vitamin E acetate.

Early research shows vaping liquids and oils — even once — can harm your lungs. Because vaping is new and hasn’t been well studied, there could be harmful effects of vaping that aren’t yet known.

Some states with legal marijuana are proactively warning marijuana users that vaping liquids has been known to cause severe lung injuries and death.

To stay up to date on the latest vaping-related illness news, check the CDC website for regular updates.

Smoking uses dried plant parts or concentrates

There are several ways to smoke marijuana:

  • One way is to roll dried parts of the flower into a joint using cigarette paper.
  • Some people mix their marijuana with tobacco, so it’s a bit less potent (this is called a spliff).
  • Some people use bongs or pipes to smoke.
  • Sometimes people smoke more potent forms of marijuana than the flower, called concentrates. These include hash and kief.

Vaping uses concentrated extracts or ground dry herb

When people vape, they consume concentrated marijuana. It seems to be a much more potent delivery system than smoking. In other words, you’ll get more high from vaping than from smoking.

Vaping can be more intense

Researchers have determined that the effects of vaping marijuana are much stronger than smoking.

In one study , researchers found that first-time and infrequent marijuana users were more likely to experience adverse reactions from the enhanced delivery of THC caused by vaping when compared to smoking.

Both take effect fast

Both smoking and vaping have an almost immediate effect on the body. Their effects peak within 10 to 15 minutes.

Most experts recommend starting vaping or smoking very slowly, taking in a small amount at first and waiting 20 to 30 minutes before having more.

A note about marijuana strains

There are many strains of marijuana, each having slightly different effects on the body. Sativa strains are thought to be more stimulating. Others, called indica, are more relaxing. It’s worth noting marijuana strains can affect people quite differently. Just because a certain strain has purported properties doesn’t mean you’ll get those exact effects.

If you’re trying to untangle the sticky subject of marijuana today, let’s look at what’s known about vaping versus smoking weed.

What Are the Effects of Mixing Nicotine and Cannabis?

Tobacco and cannabis have a strange relationship, one that has lasted for centuries but has been continually turbulent. Why do so many people use the two together? As usual with cannabinoid science, the truth is stranger than anything that could be dreamed up.

Tobacco and cannabis have been consumed together for centuries by people all over the world. In fact, it is thought that up to 70% of people that use cannabis also use tobacco. Even in North America, where cannabis is traditionally smoked pure, many users also use tobacco.

In fact, it is common in North America to smoke cigarettes immediately after smoking cannabis. This is likely to produce similar synergistic effects to actually mixing the two together (many do so for the perceived experience of getting “more high” as a result).

Differences in effect are widely reported

Many users report subjective differences between the effects of cannabis alone and cannabis when mixed with tobacco.

The most common reported effect of smoking tobacco alongside tobacco is an intensification of the high, although some report that tobacco use actually has the opposite effect and reduces the high. Another commonly reported effect is to calm the user down from the sometimes anxiety-inducing effects of cannabis.

The biological mechanisms behind this strange relationship are wildly complex. They are linked to various other processes now known to be related, but long believed to be essentially separate. The more we learn about these interlinked systems of reward, craving, addiction and satiety, the more we begin to understand that every aspect of our brains and bodies is inseparably intertwined.

Cannabis, tobacco and the hippocampus

A widely-reported recent study correlated long-term heavy cannabis use with reduced volume and density of the hippocampus, an area of the brain that is associated with memory, inhibition and addiction.

This was also demonstrated in this study from 2011, although the effect here was found to depend on various factors including ratio of THC to CBD. More specifically, higher THC and lower CBD was associated with a volume reduction in the right hippocampus. This indicates neurotoxic effects of THC and neuroprotective effects of CBD.

At least one other study has found no long-term change, and one study highlighted the possibility that genetic differences may alter the hippocampal response to cannabis use. This reduction in size was found both in cannabis-only users and in cannabis/tobacco users. It was not found in nicotine-only users, though.

In cannabis-only users, the small hippocampus was found to correlate with poor memory. This is unsurprising, as good hippocampal health and size usually correlates positively with good memory in children, adolescents and young adults. So within the group, the smaller the hippocampus, the poorer the memory.

However, the researchers also found something very surprising: in the cannabis/tobacco-using group the reverse was true, and smaller hippocampal volume correlated with improved memory! Subjects that smoked higher numbers of cigarettes exhibited greater decreases in hippocampal volume, and relatively higher memory scores (although memory was still generally poorer than in all other groups).

While this study was limited in scope and design, establishing correlation but not causation, it still demonstrates an unusual effect, and one that has yet not been fully explained. It is important to note that as a cross-sectional study looking at a brief window of time, it is inferior to a longitudinal study. One which would follow subjects for extended time periods to better track changes and establish causation.

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Effects of Cannabis on the Male and Female Reproductive System, and Fertility

How all the main regulatory and signalling systems are linked

It now appears that tobacco, cannabis and other psychoactive substances such as opioids are all linked together in a complex network of stimulus and reward, with the hippocampus essentially functioning as the HQ for operations.

Throughout the body, and particularly in the brain, we have cannabinoid receptors (which are part of the endocannabinoid system) as well as opioid and nicotinic receptors. Within the brain, densities of these receptors are extremely high in the hippocampus and are also very high in the amygdala (both areas are heavily associated with stimulus, reward, addiction and so on).

The agonists (activators) of these three types of receptors (of which the best known are THC for the cannabinoid receptors, nicotine for the nicotinic receptors and morphine for the opioid receptors) are hugely important in terms of the psychoactive and physiological effects they can exert. In fact, even substances that inactivate the receptors (like CBD for the cannabinoid receptors and naxolone for the opioid receptors) are of great interest due to their opposite effects.

How deeply are these systems interlinked?

While we’ve known about these systems for years, we are only beginning to understand the extent and depth of the connections that they have with each other. It is difficult to really see them as separate systems at all, given the innumerable, criss-crossing links that flow back and forth between them.

Here is a brief look at how these systems can affect each other. We know that nicotine itself acts on the opioid (and possibly cannabinoid) receptors, as well as the nicotinic receptors themselves. We also now know that subchronic exposure to nicotine increase the numbers of CB1 receptor in the hippocampus and decrease in striatal cannabinoid CB1 receptors.

We now also know that substances that block the CB₁-receptors can cause people and animals to stop craving both nicotine and morphine. Thus, agonists of the CB₁-receptors may cause increased cravings for nicotine, which may explain the common desire to smoke cigarettes immediately after cannabis, or the heightened subjective level of satisfaction derived from smoking the two together.

In fact, it seems that to get any “rewarding” effect at all from using sugar, nicotine, alcohol or cocaine, we need to activate the cannabinoid receptors; no activation, no release of dopamine and no subject experience of pleasure!

There also appears to be a genetic element to all this — variations in the CNR1 gene (which encodes for the expression of CB₁-receptors) are associated with variations in susceptibility to nicotine dependence. This association is found in white females but not white males (whites were the only race tested in the study).

So what does all this mean?

Well, we’re still a long way from developing a precise understanding of all the different processes that occur in the brain in response to the introduction of psychoactive substances, alone or in combination.

But we are now beginning to come to terms with this vast complexity, and to realise that investigation of any substance use or abuse or any psychiatric illness cannot be done in a vacuum. For example, we can no longer point the finger at cannabis and blame incidences of psychosis solely on its use, now that we are aware of exactly how much influence other factors such as nicotine use may play.

We can now view this vast and interconnected system for what it is and we can make nuanced judgements on individual cases, based on a much wider and more cohesive set of factors, influences and interrelationships.

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Acute and Long-Term Cognitive Side-Effects of Cannabis

So how do we put this knowledge into practice?

The interactions between nicotine and THC are complex and heavily dose dependent. It is no doubt dependent on a host of other variables that science is either unaware of or is just beginning to grasp.

Tobacco use has often been overlooked when investigating the cognitive and psychiatric effects of cannabis, despite the established knowledge that nicotine is a psychoactive substance in its own right. This oversight seems even more egregious when considering the extremely high incidence of cigarette smoking among sufferers of certain psychiatric conditions, including schizophrenia.

Indeed, recent research is finally beginning to tackle this subject head on, and has somewhat unsurprisingly found that nicotine is strongly associated with development of psychosis! The author of this recent study, James McCabe of King’s College London, is on record as stating “it might even be possible that the real villain is tobacco, not cannabis”.

Nicotine is generally negative for health and should be avoided. However, studying the differences between users of nicotine and cannabis alone compared to users of both has given us some important insights into the interconnected nature of the brain’s signalling and reward systems.

From this and other relevant research, we now know that the endocannabinoid system is heavily involved in the regulation of stimulus and reward and has a huge part to play in addiction to substances such as nicotine and morphine.

Some say cigarettes boost your high, others say nicotine ruins your high. Here is what the limited research says on mixing cannabis and nicotine.