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To Vape or Not To Vape

Although cannabis itself is not harmful to health, method of administration can be detrimental to lung function. Pulmonary (lung and breathing) troubles are well-documented side effects, with daily smokers having decreased lung capacity, coughing, and sinus problems exacerbated by frequent smoke inhalation. This would be true of any combusting plant matter inhaled directly due to carbon monoxide, but cannabis plant material can also contain tars and produce other noxious substances when burned. Increasingly doctors are recommending vaporizer use to daily or frequent cannabis users to decrease harmful side-effects of smoking while maintaining potency and ease of dosing. This will be the first article in a series of articles about vaporizing, and will focus on the benefits and disadvantages of vaporizing.

What is a vaporizer? A vaporizer is a device that heats cannabis to temperatures that release cannabinoids into air (vaporization). This vapor is then inhaled, without any smoke or combusted plant matter. The first vaporizers were very crude, home-built devices that used heating elements like soldering irons to directly heat the cannabis matter. However, over time, as companies began to emerge to serve demand from users wanting a better vaporizing experience, more complex designs emerged. Although many designs still use direct heat conduction, the more expensive but more consistent vapor design relies on using convection heating. In this method, air is heated first and then driven through the cannabis matter, assuring a more even temperature distribution as well as preventing the matter from getting too hot and partially combusting on the surface with direct heating. Several styles of both heating arrangements exist, with some having the user draw air through a tube called a “whip”, and others filling bags or storage vessels with vapor to be consumed at ease.

By not burning the plant matter, the vaporizer eliminates three specific toxins completely – naphthalene, benzene, and toluene. To give context, naphthalene is commonly used in moth balls, and benzene is a known carcinogen with a zero risk-free level of exposure. The idea is that by not producing these products at all, vaporizers result in better health – specifically lung function. However, while these effects are obviously subjective as they drive vaporizer sales, few rigorous tests have documented the difference between vaporizing and smoking directly.

One study set out to make direct quantifications. To go about this, the research group gave daily cannabis smokers vaporizers, with the instructions to exclusively use the vaporizer for one full month. Both before and after the study, lung measurements were made to establish best forced expiratory volume (FEV) of lungs, as well as forced vital capacity (FVC), two common measurements of lung function that are easily reproducible. As it turned out, changes in lung function were small but significant in merely a one-month period. Changes for FEV ranged from 7% to 10% increases, and from 2% to 7% increases for FVC. The ratio between these measures, which is known to be indicative of lung health, also improved. Half of these smokers were also cigarette smokers who decreased cigarette smoking during the same time period, which makes it difficult to ascertain for those patients what lung function increases occurred purely as a result of cannabis smoking cessation. The study itself only included four subjects, which makes it virtually dismissible scientifically, especially considering the self-reporting and possibilities for bias present in the study design. However, what is interesting to note is that none of the patients, biased or not, chose to continue smoking after the study.

Beyond health, effectiveness in THC and cannabinoid administration is an obvious consideration. One barrier to testing effectiveness of cannabinoid delivery lies in the organic nature of flower products with naturally diverse distribution levels of THC and other cannabinoids throughout the plant matter. To get around this, one laboratory employed an easily consistent cannabinoid concentrate tested inside the well-known Volcano vaporizer manufactured by German company, Storz & Bickel. To account for vapor lost to condensation inside the collection bag and other areas of the machine, the group also dismantled the vape and dissolved excess residue. In these findings, the volcano delivered 53% of THC in the cannabis material to users’ lungs, which compares with a range of 34% to 69% found in smoking methods. In other words, the delivery is competitive quantitatively. Combined with the ease of titrating amount of medicine inherent in inhalation as opposed to eating cannabis, this establishes vaporizers as a very viable option for medical cannabis delivery.

A final consideration in vaping is a matter of personal preference in taste. With vaporizers, no smoke exists to obscure the natural terpenoids of the plant, allowing a much more delicate and expressive cannabis flavor. Using a vaporizer is more akin to heavy aromatherapy than smoking. This can often result in individuals that are used to smoking, to over-consume on their first vaporization session. However, many individuals also prefer the familiar taste and smell of burning cannabis, having grown accustomed to this method of inhalation. The sensations are inherently different and patients have strong sentiment on both sides.

As one study noted, however, “the acceptability of the vaporizer to regular users…is also poorly understood.” Smoking and smoke itself have an inherent aesthetic attraction well documented in art and movies to set scene moods. Smoking from traditional rolling papers also offers the patient the ability to easily dispose of the cannabis and paraphernalia when entering an area restricted to the medicine. While there are disposable vaporizers, these are cost prohibitive to someone frequently needing to administer and dispose of their medicine. However, from the rise of pen-vapes to the growing percentage of patients that use vaporizers at home, it seems evident that vaping holds a large future in the area of medical cannabis.

In the next article about vaporization, we will explore how vaporizing affects the levels of terpenoids, cannabinoids, and other substances found in cannabis during inhalation as opposed to smoking. Since these chemicals affect the specific experience of medicating with cannabis, vaping, in turn, creates a qualitative difference in medicating.


Works Cited

Mitch Earleywine and Nicholas T. Van Dam. (2009) Addiction Research and Theory. June 2010; 18(3): 243-249

Arno Hazelkamp, Renee Ruhaak, Lineke Zuurman, et. al. (2005) Evaluation of a Vaporizing Device (Volcano) for the Pulmonary Administration of Tetrahydrocannabinol. Wiley InterScience DOI: 10.1002/jps.20574