Is Smoking Cannabis Ever Healthy?

So, we’ve come to a point culturally where (most) people are finally aware of — and embracing! — the truth: cannabis is healthy.

Since the lift of prohibition in several states across the US, more and more research is being conducted in labs from coast to coast. And the more studies come out, the more we know about this incredible plant, and all it’s beautiful healing powers. 

So yes, THC, CBD, and the whole flower of this plant have fascinating pharmacological capabilities, meaning they fit quite nicely into the health and wellness lifestyle. You’re starting to see major fitness brands like SoulCycle carry CBD cream in their grapefruit-scented studios, and CVS now carries CBD topicals alongside Epsom salts and Band-Aids. But do lighting up a joint or vaping — even without nicotine or tobacco — pose risks to your health? Should we be smoking at all?

Obviously much of this comes down to personal preference and needs. For some, vaporizing and smoking allows for the quickest delivery of cannabis’ medicinal compounds, through the respiratory system. As such, the patient using smoking or vaporizing as their delivery method experiences lightning fast relief, whether they’re battling chronic pain, an anxiety attack, or insomnia.

We chatted with Dr. Jordan Tishler, MD, Dr. Perry Solomon, MD, and Dr. Herve Damas, MD to see what the potential risks are when it comes to smoking cannabis, so you can weigh the pros and cons when it comes to your health.

The Low Down on Smoking

“Smoking healthy? Almost an oxymoron,” said Dr. Solomon, but that doesn’t mean it’s necessarily bad for you. “There is some evidence that smoking cannabis can be a bronchodilator,” he explained, and said that “There doesn't seem to be a link between smoking cannabis and lung cancer like tobacco.” 

Dr. Tishler confirmed this. “The data on long term cannabis smoking are surprising,” he said, noting that it’s quite “different from what we’d expect from the tobacco literature.” Read: not bad. “Donald Tashkin, a pulmonologist from UCLA, has followed recreational ‘heavy users’ [of cannabis smoking] for about 25 years and found no increase in cancer or emphysema,” said Dr. Tishler. 

Keep in mind, this study isn’t definitive. “It is worth noting that ‘heavy user’ was defined as one gram per day (or one ounce per month, so we know some users are above that level) and that 25 years really isn’t long enough to conclude it’s safe,” he said.

In addition, smoking “can irritate your lungs and make you cough,” said Dr. Solomon. “All of this doesn't mean it's safe or unsafe, it's just personal preference.”

According to Dr. Damas, there are plenty of risks to keep in mind from smoke inhalation, regardless of what it is you’re smoking. “Smoking does put you at risk for emphysema/COPD and bronchitis,” he says, and it can “exacerbate asthma and cause damage to the interstitium (the fibrous structure) of your lungs.” Not super chill. “This can lead to apical emphysema, and formation of large pockets of air called bullae,” which in turn can rupture (fun), which leads to a condition called pneumothorax. “A constellation of findings of this nature is often referred to as marijuana/pot-smokers lung,” he said.

But there are benefits — in fact, it’s arguably the fastest way to get the medicinal benefits of cannabis. “Smoking and vaping fall under the category of ingestion called inhalation,” said Dr. Damas. “The benefit of Inhalation is that it allows for fastest delivery of the medicine to your bloodstream and subsequently your cellular receptors. It bypasses what is referred to as first pass metabolism which takes place in the liver.”

To Vape or Not to Vape

WARNING: Vape cartridges contain marijuana smoke, a chemical known to the State of California to cause cancer.

Maybe you’ve seen this on labels and product descriptions while shopping for your own vaporizer cartridge — but is it trustworthy?

“If done correctly,” said Dr. Tishler. “But many are not.” Here’s the deal: “Vaporization should be free of all carcinogens and particulates associated with smoke, but the key is proper temperature control,” he said. “At 350ºF we get the medicine, but no products of combustion. However, at 400ºF we start to get products of combustion.” 

“As you can see, the window is pretty narrow,” he continued, “and many flower vaporizers and ALL oil vaporizers fail to control temperature precisely enough. The machines that are effective are slightly larger as they have a microprocessor-controlled thermostat that makes it work properly.”

So that’s the tricky part — vaporizing can be safe, provided that you’re using a clean product and you’re using a pen that keeps the temperature controlled to exactly 350 degrees. But it can get into dangerous territory just fifty degrees up from there.

“Vaping is relatively new, and there aren't long term studies,” said Dr. Damas, “But is proposed as a ‘safer’ alternative — but there isn't enough scientific evidence to corroborate any of those claims,” he said. “We do know that vaping puts you at risk for ingestion of solvents that you wouldn't typically [consume when using] the flower,” (read: the entire cannabis flower, which doesn’t apply if you’re only looking to get CBD and not the other phytocannabinoids). “The long- term effects of these solvents have not been investigated, although the most popular propylene glycol is considered to have ‘low toxicity.’” This means it’s potentially safe, but TBD.

Is It Worth It?

“Burning any substance and inhaling can be detrimental to your health,” said Dr. Damas. “Not only do you have to consider the deleterious effects of any toxins or carcinogens in any of the papers or wrappers that you may use, but also the effects of inhaling smoke itself.”

Many people can comfortably use a vape pen with no issues, and others seem to be more negatively affected. It might seem obvious (but you never know!), but if you have asthma, respiratory issues, or any preexisting lung conditions, you’ll want to confer with your doctor before starting a CBD or cannabis vape regimen — or maybe skip it entirely. 

If you fall into that camp but still want quick effects of CBD, you’ll want to opt for a potent sublingual tincture. “If a person does not want their lungs to be exposed to smoke, or doesn’t want to be inhaling particles, and they still want the exposure to cannabis and its benefits, I would stay away from smoking/vaping,” said Dr. Solomon. “Tinctures, edibles, tablets, dissolving strips even suppositories are ‘easier’ ways to use cannabis with a longer onset time.”

Dr. Damas agreed, saying “Sublingual’s allow you to get absorption faster than eating but slower than inhalation, [with] none of the risks of smoking.” Dr. Tishler noted that there aren’t many studies to back this up either, but we’ll certainly learn more as research continues to unfold in real time.