Cannabis has always been associated with traditional smoking methods. Today, patients can choose from many different non-inhalable intake methods, including edibles, tinctures, and capsules.
When the legislature for medical marijuana in Florida was passed in 2016, it did not include the smokable form of cannabis. Qualified patients could legally purchase products such as vape cartridges, shatter, RSO, sublingual oils, and suppositories – but no smokable flower was allowed. Other states, such as Texas, still have a ban against smokable flower.
A part of the reasoning behind this was the concern over the safety of inhaling combusted cannabis. When it comes to intake methods, smokable cannabis flower has the highest risk of causing lung damage and inflammation in your respiratory tract.
Suppose you are a patient who has respiratory problems, such as asthma, emphysema, or chronic obstructive pulmonary disease (COPD). In that case, there are some important things to consider about smoking methods and other alternative routes.
The Safety Of Combusting Cannabis
Some people have a distinct memory of the first time smoking weed: inhalation, followed by a massive coughing fit. The vapors that you inhale when you smoke cannabis flower have irritants that make your body react that way. And it doesn’t matter if you are inhaling through a pipe or bong (smoke over water) or smoking joints (pre-rolls).
Cannabis Has Some Of The Same Carcinogenic Chemicals as Tobacco Smoke
While smoking marijuana is the most well-known consumption method, it is one of the most harmful ways of consuming cannabis. Smoke is detrimental to a person’s lung health, whether from burning wood, tobacco, or cannabis, because there are carcinogens and toxins released from the combusted material.
While it is true that there are far fewer carcinogens found in cannabis clouds (compared to cigarette smoke), marijuana smoke has been shown to contain some of the same irritants and toxins as tobacco does. The risks are lower, but smoking weed or vaporizing it can increase your respiratory cancer risk.
Holding In Your Cannabis Smoke Is Bad For You
There is a pervasive myth that if you inhale cannabis smoke and hold your breath (allowing the smoke to pool in your lungs), you will get high more quickly. Or that the method will produce more intense psychoactive effects. Neither one of those facts is accurate.
Cannabis users tend to inhale the smoke more deeply into their lungs, and they hold their breath longer, which leads to greater exposure to tar per breath. The THC in cannabis smoke, minor cannabinoids, and terpenes are rapidly absorbed through the lungs. Thanks to the human body’s endocannabinoid system, cannabis molecules are readily accepted. Holding your breath won’t make the effects “kick in” sooner or amplify your psychoactive experience.
Marijuana smoke can cause chronic bronchitis, and marijuana smoke has been shown to injure the large airways’ cell linings, which could explain why smoking marijuana leads to symptoms such as chronic cough, wheezing, phlegm production, and acute bronchitis. Smoking cannabis has also been associated with cases of air pockets developing in between both lungs and between the chest wall and the lungs.
The smoking method of cannabis consumption has also been linked to large air bubbles in the lungs among young to middle-aged adults, with higher incident rates among those who use smokable cannabis heavily. However, more research is needed to know for certain whether these occur more frequently amongst marijuana smokers than the general population.
Smoking Impairs The Human Immune System
Smokable cannabis can also affect the immune system and the body’s natural ability to fight disease. This is especially true for those whose immune systems are already weakened from immunosuppressive drugs or diseases like HIV infection.
Smoking marijuana harms the lungs’ first line of defense against infection by suppressing cells that help remove dust and germs and cause more mucus to form. It also suppresses the function of the immune system.
These effects could lead to an increased risk of lower respiratory tract infections among cannabis smokers. However, there is no clear evidence of such actual diseases being more common among marijuana smokers. Yet frequent marijuana-only smokers have more healthcare visits for respiratory conditions compared to nonsmokers.
Studies have shown that smoking marijuana may increase the risk of opportunistic infections among those who are HIV-positive. However, it does not seem to affect the development of AIDS or lower white cell counts.
Another potential threat to those with weakened immune systems is Aspergillus, a mold that can cause lung disorders. It can grow on marijuana, which, if smoked, exposes the lungs to this fungus.4 However, it rarely causes problems in people with healthy immune systems.
Methods of Smoking Medical Marijuana
Glass Pipes
Glass pipes, also known as bowls, are one method of smoking cannabis. There is a wide variety of pipes to choose from, from small one-hitters (sometimes called ‘chillums’) to big artistic-looking bowls. These pieces are great for individual use but can also easily be re-lit and passed around.
Some downsides to smoking out of glass pipes are the cost of purchasing one, the ability to break them easily, and the harshness of not having anything to filter the toxins or the harshness of the smoke.
Water Bongs
Bongs are similar to a glass pipe but have several added features to enhance the smoking experience. They have a chamber to hold water that cools down the smoke as it passes through, making the hit of smoke less harsh and more comfortable to inhale.
Some bongs even come with additional percolators that filter the smoke even more for a better experience, and others are designed to hold ice to cool the temperature of the cannabis smoke further. Bongs are notoriously tricky to sanitize or clean.
If you are new to using smokable cannabis, please note that a bong produces a very dense inhalation. The bigger the bong, the heavier the “hit,” which means you absorb more smoke and harmful byproducts. You are more likely to experience a brief coughing fit after inhaling through a bong that has wider channels than a hand pipe.
Cannabis Pre-Rolls
Rolling up a joint is a great way to smoke cannabis. They can be rolled as small or as large as needed and will make the flowers true taste peak through. This option is excellent for smoking outdoors as the smell of the smoke will linger in the air.
Pre-rolls purchased from a dispensary are usually organic fiber cones. However, if you roll your own at home, pay close attention to the ingredients in your rolling papers. Flavored joint papers can also contain hazardous chemicals, such as cellulose nitrate, which is a known carcinogen.
Tobacco Blunts
Blunts are a type of cigar wrap that can be used to roll up cannabis flower. It is similar to a joint, except the papers are more harmful and cause a thicker smoke. The effects produced by a blunt will be different than from a joint or bong because you are mixing the cannabis effects with the effects produced by the tobacco wrap.
Cigars are not inhaled into the lungs because of the density of chemicals and carcinogens produced by the tobacco leaves. However, people roll blunts because they enjoy combining the stimulant effects of nicotine with cannabis. There is approximately 1.2 to 6.0mg of nicotine in one cigar wrap.
Smoking blunts is the most harmful way of smoking marijuana because of the other tars and chemicals found in the blunt wraps. Blunts are equivalent to “doubling up” on the harmful carcinogens in both tobacco and smokable cannabis flower.
Vaping is a Healthy Smoking Alternative
One healthy way of inhaling whole cannabis flowers is by using a vaporizing device. These come in all shapes, sizes, and prices to meet the needs of each user. Vaporizing cannabis removes approximately 95 percent of the smoke that is inhaled.
A vaporizer steadily heats herbs to a temperature that is high enough to extract THC, CBD, and the other cannabinoids and terpenes present in the plant. The temperatures are too low for the potentially harmful toxins released during combustion, minimizing the health risks associated with smoking. It has also been suggested that it can increase the yield of anti-inflammatory terpenoids that protect the lungs from irritation.
Another great thing about vaping whole flower is the ability to reuse the already vaped product. Since the material is not getting burned, it gets saved rather than turning to ash. The leftover flower is decarboxylated and perfect to use for infusions once it has been washed.
Reduce Your Risks When Smoking Weed
If you would still rather smoke whole flower despite the risks that come along with it, there are some important ways you can make smoking cannabis less harmful to your health. Proper care and hygiene for your glassware can make a big difference.
Use Glass Bongs and Pipes
Plastic bongs contain chemicals like BPA and phthalates that are linked to severe health effects, including cancer. Plastic is also porous and can absorb chemicals and microbes. Some metal pipes may also have harmful coatings that can pose a risk to your health.
Keep Your Accessories Clean
Keep your pipes and other smoking devices clean. Buildup and residue, including fungi, mold, and bacteria, can harm the lungs. Also, do not put your flower on dirty surfaces or in the open air. Keep your medical cannabis in an airtight container to preserve quality and reduce the risk of contamination.
Don’t Hold Your Smoke
Inhaling deeply and holding it in for long periods exposes the lungs to more tar and cancerous chemicals per breath. It has no impact on how “high you get” or how quickly you feel the psychoactive effects of your smokable medical cannabis. Your lungs will thank you.
FDA-Approved Rolling Papers
Do you know where your rolling papers are manufactured? It’s important because other countries do not have the same safety concerns or standards as the United States. Some papers contain harmful chemicals and flavorings that can be toxic and cancerous. Look for domestically produced papers that the FDA has approved.
Alternatives Non-Smoking Ways to Consume Cannabis
There is no safe way to inhale cannabis, but the good news is there are plenty of other ways to consume it that do not pose the same risk of lung and respiratory damage. Not only are alternative methods easy to consume (no grinder, rolling papers, or pipe required), but they are also less scentless and less conspicuous.
There are many other methods of taking marijuana and a diversity of products available at your local dispensary, which include:
- Tinctures
- Capsules
- Edibles
- Topicals
- Suppositories
Using a suppository is not everyone’s first choice, but it can be an effective intake method for patients who experience digestive problems, such as nausea, and those who find edibles difficult to consume. Suppositories are also ideal for convalescing patients or individuals in end-of-life (compassionate) care.
Topical creams can help provide localized relief, allowing cannabinoids to be absorbed through the skin (but not into the bloodstream). This may be ideal for individuals who experience chronic inflammation, joint pain, and other chronic pain symptoms.
Not sure what intake method is best for you? Ask your DocMJ provider at your next visit. When you talk to a medical marijuana doctor, recommendations can be provided based on your personal needs and wellness goals.
Aaron Bloom, an experienced healthcare attorney, serves as the CEO of DocMJ and Medwell Health and Wellness Centers, where he has overseen the organizations’ mission and growth since 2016. In addition to his leadership roles, Aaron serves on the Board of Directors for Waterfall Bank, bringing his expertise in healthcare, compliance, and strategic growth to the financial services sector.
Aaron’s passion for improving patients’ lives stems from more than 20 years of owning, operating, and representing traditional healthcare organizations. Throughout his career, he has remained committed to finding better ways to relieve suffering and expand access to innovative, patient-centered care. As CEO, Aaron works each day to help patients achieve better health and wellness through the therapeutic benefits of medical cannabis and other evidence-based alternative medicines.