In the early 2000s, vaping emerged as a popular alternative to smoking tobacco. E-cigarettes, marketed as nicotine delivery systems without the harmful chemicals found in traditional cigarettes, quickly gained popularity. As vaping technology evolved, so did its applications. By the mid-2010s, the marijuana industry began to adopt vaping as a method for consuming marijuana. This shift was possibly driven by the increase in legalization across states, the perception that vaping was safer than smoking, and the convenience of discrete portable vapes. However, as the popularity of marijuana vaping grows, so does the rise in its health effects.

By 2019, reports of lung injuries associated with vaping began to surface. Studies found that the combination of vaping marijuana, smoking tobacco and smoking marijuana was linked to younger individuals experiencing lung conditions in a short period. The Centers for Disease Control and Prevention (CDC) then identified a condition known as EVALI (e-cigarette or vaping product use-associated lung injury), which was linked to THC containing vape products. A chemical used to dilute THC and create low-cost products contributed to an outbreak of EVALI. CDC reported that as of late 2019, approximately 77% of vaping-related injury cases involved THC-containing products. By February 2020, this number increased to 80%, highlighting a significant association between marijuana vaping and respiratory complications.

The increased access to marijuana through online retailers and the rise in marijuana legalization across states has contributed to the increase in marijuana use by young adults posing new challenges. A 2024 meta-analysis found that the passing of recreational marijuana laws led to an increase in past-month marijuana use of 13% among youth and 22% among young adults.  In addition to this analysis, the Monitoring the Future Survey revealed that marijuana and hallucinogen use among 19–30-year-olds remained elevated compared to previous years. When including vaping of either nicotine or marijuana, both trends showed a consistent increase over the past five years and are now at record levels. Specifically, the percentage of 19–30-year-olds who vaped marijuana in the past 12 months rose from 11.5% in 2017 to 22.2% in 2023, while vaping marijuana in the past 30 days increased from 5.9% to 14.4% over the same period. This aligns with the growing perception that vaping is a healthier alternative, leading more young people to experiment with these substances, potentially leading to a higher incidence of lung-related health issues.

The increase in demand for marijuana products has also driven the development of efficient delivery methods, such as online retail, introducing new challenges for regulation. A study highlighting the significant gaps in regulatory compliance among online retailers of flavored tobacco and marijuana vape products showed that, out of 156 purchase attempts, 67.3% were successfully delivered, including to areas with flavor restrictions. Worryingly, only 1% of buyers had their ID scanned successfully by delivery personnel, as required by law, with most deliveries not conducting ID check or interacting with purchaser. These findings underscore the need for better enforcement of age verification and shipping restrictions, especially as youth and young adult use of marijuana vape products increase.

The story of vaping’s evolution from tobacco to marijuana serves as a reminder of the complexities and unforeseen consequences that can arise with new technologies and changing substance use trends. As legalization and acceptance of marijuana continue to grow, so does the need for comprehensive research, clear regulations and widespread education to ensure public safety and prevent unintended consequences.

References

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