The use of marijuana for medicinal purposes has been a topic of controversy throughout the medical and political worlds for decades.

While marijuana, also known as cannabis, has been used for thousands of years in healing and treatment, it’s currently illegal in many U.S. states.

Regardless of its legal status, the question remains as to whether smoking marijuana is harmful to our lungs, especially for people living with chronic obstructive pulmonary disease (COPD).

In the last several years, many people with sensitive lungs have turned to vaping with the idea that it’s a safer smoking experience. But is vaping safer than smoking? Can people with COPD experience marijuana’s benefits from vapor?

Marijuana may provide calming effects that improve certain mental and physical conditions. For instance, a doctor might recommend medical marijuana to people with Crohn’s disease as an alternative way to ease inflammation, nausea, and vomiting.

Studies are currently underway to evaluate the benefits of cannabidiol (CBD), a chemical compound found in marijuana. CBD shows promise as a treatment for a variety of medical conditions, including:

Two drugs that are a synthetic laboratory version with chemical structure of or similar to tetrahydrocannabinol (THC), another active ingredient in marijuana, are approved for use by the U.S. Food and Drug Administration (FDA).

Dronabinol (Marinol) and nabilone (Cesamet) are approved to treat nausea due to chemotherapy and to assist in helping to achieve weight gain in people with AIDS.

The mouth spray nabiximols (Sativex) treats nerve pain and muscle control problems associated with MS. It contains both CBD and THC. It’s been approved for use in Canada and in countries throughout Europe. However, it’s yet to be approved by the FDA.

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Marijuana doesn’t have the exact same negative effects as smoking cigarettes. However, most health experts still warn against smoking the drug. That’s because smoking marijuana can harm your lungs or worsen respiratory issues that already exist for you.

Even though cannabis rarely contains nicotine, marijuana smoke does contain harmful chemicals. These chemicals include:

  • airway irritants
  • tumor promoters, including carcinogens, which are cancer-causing substances

Research shows that smoking marijuana also causes visible and microscopic injury to the large airways. This is associated with an increased likelihood of developing chronic bronchitis.

The inhalation patterns when smoking marijuana are different than when smoking cigarettes. Studies have shown that marijuana smokers tend to take larger puffs, inhale more deeply, and hold their breath longer when compared to those who smoke cigarettes.

The damage to the lungs from smoking marijuana, in which abnormal, large air sacs called bullae form and can rupture, may be the reason marijuana smokers are at risk for developing a pneumothorax, which is when air gets into the space outside the lungs and causes a collapsed lung.

Marijuana smokers tend to have more cough, mucus, and wheezing in comparison to people who don’t smoke. Learn more about the effects of marijuana.

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COPD affects about 30 million people in the United States. Most cases are caused by smoking cigarettes and other tobacco products. Other cases are the result of air pollution, chemical exposures, fumes from fuels burned for cooking, or genetics.

Smoking marijuana may increase your risk for developing COPD. If you already live with COPD, it may worsen your symptoms.

Smoking marijuana can cause damage with rupture to the walls of adjacent alveoli (small air sacs in the lungs) into larger, ineffective air sacs called bullae. The risk is higher in male smokers under the age of 45.

Bullae can cause shortness of breath. They can also become infected or rupture, causing the lung to collapse. People with significant bullae may require surgery for treatment.

Marijuana smoke may also increase the risk of developing lung cancer, according to the American Thoracic Society (ATS).

It’s important to keep in mind that it’s the chemicals in smoke that can be harmful, regardless of what you’re puffing on. Marijuana contains over 450 different chemicals, some of which are linked to cancer.

“We know that smoking tobacco is very dangerous, leading to COPD or lung cancer. This has been proven beyond doubt,” says Jordan Tishler, MD, a medical cannabis specialist. “Of course, this leads to the concerns that smoking cannabis would do the same.”

Alex Berezow, senior fellow of biomedical science at the American Council on Science and Health, agrees.

“The only thing people should be putting in their lungs is oxygen. The reason cigarettes are dangerous isn’t because of the nicotine. The tar and other chemicals that cause emphysema or cancer make it so dangerous. Burning or inhaling is a bad idea. That’s why we will probably discover that marijuana is bad for your lungs, too.”

An alternative method for taking in marijuana is through vaping. Vaping involves inhaling a liquid vapor through a vaporizer or e-cigarette. Although this method has made a splash in recent years being advertised as a “safer” way to smoke, it comes with its own set of risks.

Research shows that vaporizers can release harmful chemicals into your system.

Certain chemicals, such as ammonia, can negatively interact with your central nervous system (CNS). You also face other risks, such as aggravating asthma or causing bronchial spasms when vaping marijuana.

The American Heart Association (AHA) has pushed for tougher regulations on selling e-cigarettes. These are similar in nature to vaporizers used for marijuana, and can greatly impact youth because of the potential cancer-causing substances they release.

There’s still too little research to know the extent of the risk you face by vaping marijuana. Yet, it’s important to remember that vaporizers don’t protect you from the harmful effects of the chemicals breathed in. That means they can’t be regarded as safe to use, according to the ATS.

If you do choose to vape, Dr. Tishler advises using the safest method possible.

“Not all vaporizing is the same. I recommend vaporizing the whole cannabis flower. The little pen-shaped vaporizers that have become very fashionable and use cannabis oil should be avoided,” he says.

“The cannabis in those devices is most often thinned with propylene glycol or polyethylene glycol. Neither of these are safe to heat and inhale. There are alternatives for patients who find loading a conventional vaporizer with ground cannabis is too much for them. I’d recommend looking into a pod-based device.”

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If you’re trying to avoid respiratory risks, there are still ways to ingest marijuana. Edible marijuana products, also called “edibles,” are thought to do far less damage to your respiratory system.

Edibles come with their own setbacks, however. They’re usually slower to take effect and can also last longer than you might want. The dosage is also harder to determine.

This increases the risk of toxic doses and can cause other complications, including:

Life-threatening doses rarely occur but have been associated with death due to heart attack and sudden cardiac death, an unexpected failure of the heart’s electrical system.

There are other methods for taking in marijuana, including:

  • sublingually, which is under the tongue
  • rectally
  • via transdermal delivery, which is through the skin

Keep in mind that there’s little research on the risks and benefits of these methods.

The research on medical marijuana looks promising. However, we still don’t know whether it’s an effective treatment. Beyond that, only 31 states, as well as Guam, Puerto Rico, and the District of Columbia allow the use of marijuana for medical use.

If you’re interested in this potential therapy and live in an area where medical marijuana is legal, consider discussing it with your doctor. They can work with you to determine whether this is an option for you.

Your doctor can also guide you through other treatment options, and together you can develop the best strategy.

Foram Mehta is a San Francisco-based journalist by way of New York City and Texas. She has a bachelor’s of journalism from The University of Texas at Austin and has had her work published in Marie Claire, India.com, and Medical News Today, among other publications. As a passionate vegan, environmentalist, and animal rights advocate, Foram hopes to continue using the power of the written word to promote health education and help everyday people live better, fuller lives on a healthier planet.