Health risks and considerations for smoking weed

When it comes to inhaling cannabis, consumers are spoiled for choice. The abundance of ways to inhale weed comes with considerations and risks, however. For the health-conscious, safety leads the list of concerns. 

Inhaling marijuana is often associated with issues such as lung inflammation, toxin exposure, and the development of chronic respiratory illnesses. If smoking or vaping is your jam, it's essential to be aware of the respective risks and take precautions.

Here's a breakdown of the health risks associated with joints and pre-rolls, blunts, bongs, pipes, dabs, and vapes, along with helpful facts to support your safe cannabis consumption.

Joints and pre-rolls

A joint contains cannabis flower that has been rolled up in a thin sheet of smokable paper. The paper is usually made from hemp, rice, or wood pulp. A pre-roll is a joint that's ready to smoke because it was already rolled by a cannabis vendor, dispensary, or brand.

how to light a joint
A joint contains cannabis flower that has been rolled up in a thin sheet of smokable paper.
Photo by: Gina Coleman/Weedmaps

Joints are a popular way to smoke cannabis because of their simplicity. One of the advantages of smoking joints is that they are composed solely of cannabis and leave tobacco out of the mix. Joints contain nothing but cannabis and the paper it has been rolled in. 

However, joints still require combustion, which carries risks. Cannabis smoke theoretically could be just as harmful as tobacco smoke. According to the American Lung Association, cannabis smoke contains many of the same toxins and carcinogens as tobacco smoke. 

When smoked, cannabis produces about 4,000 chemicals that are mostly identical to tobacco. Smoking cannabis also entails a puff volume that's two-thirds larger than tobacco, an inhaled volume that is one-third larger, and a breath-hold almost four times the length of tobacco, which can increase the concentration of carbon monoxide in the blood by up to five times. The heat produced by the combustion of dried flower can irritate the lungs, provoking side effects such as respiratory infections, including chronic bronchitis and other illnesses.

Another issue to be mindful of is the composition of your rolling papers. Papers containing chemicals or toxins can further increase exposure to undesirable carcinogens. Opt for rolling papers from trusted brands.

Blunts

A blunt is a cigar that has been emptied of tobacco and refilled with cannabis. Generally, blunts are rolled with tobacco leaf wrappers and are longer and thicker than joints. 

rolling a blunt
A blunt is a cigar that has been emptied of tobacco and refilled with cannabis.
Photo by: Gina Coleman/Weedmaps

The tobacco in the blunt wrapper contains nicotine and a host of other chemicals that have been associated with a range of adverse effects, including cardiovascular and circulatory disorders and cancers. Cigar wrappers also contain high concentrations of cancer-causing nitrosamines. The porosity of these wrappers also plays a role in safety; research indicates that more porous paper increases the carbon dioxide yield in the smoke.

Nicotine is also an addictive substance. Both cannabis and tobacco use can lead to dependency

Blunts provide a slower burn than a joint and contain significantly more pot than a joint because you can pack a lot of flower into a cigar wrapper. In a 2009 study published in Inhalation Toxicology, researchers found that tobacco increases the vaporization efficiency of THC by as much as 45%. Blunts, therefore, can make it significantly easier to get high quickly.

Bongs

A bong is a water pipe used to smoke cannabis. The smoke is filtered through the water and travels through a tube to the mouthpiece where the user inhales it. The water-filled chamber can filter smoky soot from the burning cannabis. Bongs don't necessarily filter out more tar though, so they may actually increase tar build-up in the lungs.

man smoking bong
A bong is a water pipe used to smoke cannabis.
Photo by: Gina Coleman/Weedmaps

There's a common misconception among smokers that a water bong represents a safer inhalation method because water helps cool the smoke. It is true that the reduced heat feels less harsh and cooler smoke goes down smoother, so it's easier to gulp down a lungful and hold it longer. 

However, exposing the lungs to smoke for longer periods can scar and damage lung tissue. Damage can lead to respiratory illness, asthma, and more serious conditions like cancer. Bong use has also been linked to necrotizing pneumonia, which causes irreversible damage to pulmonary function.

Bongs also tend to encourage people to puff harder to get the THC hit, as the water filters out some of the THC content. Users then need to smoke more to reach their desired effect

Bongs also carry another caveat — they're often shared at parties or in friend circles. That can be a problem when what's also being shared are infectious illnesses. There are case reports of users contracting pulmonary tuberculosis from sharing a bong, so refrain from swapping spit and keep your bong to yourself.

If using a bong is your thing, make sure you opt for a high-quality glass or stainless steel. Avoid bongs with plastic bottles, rubber hoses, or aluminum components. Plastic is particularly problematic because it contains compounds like phthalates and BPA, which have been connected to serious adverse effects. Heating plastic can release even more undesirable toxins that you want to avoid inhaling with your cannabis hit.

And you don't have to toke so hard. Taking shallow puffs rather than deep inhalations means you can reduce lung exposure to smoke. About 95% of the THC in the smoke is absorbed in the first few seconds, so there's no need to puff hard or hold your breath.

Pipes

A pipe is a small handheld device that can be used to smoke cannabis. Pipes come in a wide array of materials, sizes, and shapes. A bong, for instance, is a large water pipe. 

ice hash bowl
A pipe is a small handheld device that can be used to smoke cannabis.
Photo by: Gina Coleman/Weedmaps

When it comes to ease of use and portability, a pipe is the go-to for many. The weed is packed into the bowl, lit, and inhaled. This ease is a double-edged sword, though. While pipes can offer a quick hit, they are also known for harsher hits that result in coughing fits. Pipes are normally used with screens that trap ash and other plant matter. But the screen can become dislodged, meaning ash, particulates, or plant fragments can be pulled through the stem and inhaled (cue the coughing fit). The potential for damaged lung function may increase if your pipe is not properly filtering out what it should.

Like bongs, pipes shouldn't be shared. Sharing a pipe with friends or in a social setting increases your risk of exposure to infectious illnesses that can be passed through saliva. If a pipe is your preferred method of smoking, glass or stainless steel pipes are best.

Dabs

Dabbing refers to inhaling vaporized cannabis concentrates through a temperature-controlled heating method such as a dab rig, e-rig, or vaporizer. As a newer form of cannabis consumption, there's still a lot we don't know about dabbing. 

taking a dab
Dabbing refers to inhaling vaporized cannabis concentrates through a temperature-controlled heating method such as a dab rig, e-rig, or vaporizer.
Photo by: Gina Coleman/Weedmaps

One thing is for sure, though: concentrates deliver significantly more THC than other cannabis products. The heavy THC hit makes for a rapid, potent high. Dabbing has been linked to tachycardia (rapid heart rate) blackouts, paranoia, and hallucinations. A study published in the Lancet suggests that exposure to high concentrations of THC may lead to mental illnesses such as psychosis. In another study published in Addictive Behaviors, participants reported that dabs led to higher tolerance and subsequent withdrawal. The researchers concluded that dabbing may be more likely to lead to addiction or dependence. 

The process used to extract concentrates from cannabis oil may also result in impurities. There's a possibility of residual contamination any time cannabis is processed, so choose tried-and-true brands that go above and beyond to filter out contaminants.

Vapes

Vapes refer to vaporizers or similar devices containing a controlled heating element. The cannabis is converted to vapor when it's heated to a lower temperature than for smoking. Both concentrates and dried flower can be vaped.

weed concentrate vape pen
Vapes refer to vaporizers or similar devices containing a controlled heating element.
Photo by: Gina Coleman/Weedmaps

There is a lot of controversy surrounding vapes following the 2019 vape health crisis. The devil is in the details, however. Concentrates containing Vitamin E acetate, a cutting agent, have been identified as the primary source of the crisis. The use of additives to thin or thicken vaping concentrates is one of the main dangers associated with this delivery method. 

Illicit vape cartridges purchased on the street or black market are far more likely to contain these harmful agents as they are unregulated. Tainted cartridges have also been found to contain additives such as pesticides, formaldehyde, with only minor levels of cannabinoids. Users who vape concentrates should only purchase cartridges from trusted suppliers retailing regulated cartridges that have been tested by third-party labs.

The risks pertaining to vaping concentrates do not apply to vaping whole cannabis flower, though. Vaping actual dried cannabis appears to be less harmful to the respiratory system than smoking. Cannabis medicine expert Dr. Ethan Russo has observed that vaporization produces significantly fewer harmful bi-products and pulmonary symptoms compared to smoking. Whole flower vaping devices are currently being refined to offer a slower, safer rate of vaporization, making it easier to avoid overdoing it or greening out.

Bottom line

As the evidence suggests, smoking cannabis is aligned with several adverse health effects that can increase with more frequent use. All cannabis inhalation methods come with their own risks that merit consideration. Vaping whole flower appears to offer the least harmful option.

If you're a smoker, there's no genuinely healthy way to smoke weed. There are, however, some actions you can take to minimize the risks.

Higher THC concentrations of herbal cannabis can mean you can achieve the desired effect using a lower amount with less puffing. Experts have highlighted that higher THC levels result in reduced smoke consumption. This approach takes care, so exercise caution and go slow to avoid overdoing it. 

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The information contained in this site is provided for informational purposes only, and should not be construed as medical or legal advice. This page was last updated on December 17, 2020.