In 2019 the E-cigarette or Vaping-Use Associated Lung Injury (EVALI) outbreak was responsible for putting thousands of people in the hospital. Many blame an agent called vitamin E acetate, while one study has pointed to a terpene called phytol as the main culprit. While the health issues stemming from vaping are likely based on a web of factors, one thing is certain: The common factor among EVALI cases to date is illegally produced and sold vape pens.
In accordance with this, a new study found that states with legal cannabis markets have been less likely to experience incidences of EVALI, suggesting that properly regulated vape pens are not the problem. The study’s authors state that the 68 deaths attributed to the 2019 outbreak were geographically “consistent with a contaminant in locally-distributed products,” revealing that the number of reported EVALI cases was more than 40% lower in states where cannabis is legal for adult use.
To conduct their study, published in the journal Drug and Alcohol Dependence in November 2021, the researchers obtained the number of (confirmed and probable) EVALI cases for each state in the U.S. After mapping the case counts alongside state cannabis policies, the team estimated the “relationship between states’ total 2019 EVALI cases and two mutually exclusive marijuana policy indicators”—the first being recreational and medical legalization, and the second being only medical legalization.
Despite the fact that policies varied from state to state, the study consistently found that the highest numbers of EVALI cases were in states with a ban on all cannabis or with medical-only policies. The report noted that the states with legalized recreational cannabis “fell into the lower two quintiles for EVALI prevalence.” The report explained that recreational legalization “could have dampened market penetration of tainted marijuana concentrates by reducing consumption of informally-sourced marijuana products more generally.”
The study also discovered impacts from other variances in policies across states. For example, the team identified a positive association between illegal combustible use (smoking) and high EVALI cases resulting in hospitalization. Because some states allow the sale of flower but prohibit smoking it, the research team speculated that users may have been driven to illicit markets and/or turned to the second most popular form of cannabis consumption: vaping concentrates.
Although smoking cannabis is the most popular consumption method overall based on the BRFSS, the study’s researchers found that states with legalized recreational and medical cannabis, or even just legalized medical, were positively associated with vaping as the “primary mode of marijuana use.” Since vapes for cannabis are near indistinguishable from e-cigarettes and produce less odor than conventional cannabis smoking, it makes sense that many consumers would be drawn to this easy-to-disguise form.
However, the study also discovered that states allowing home cultivation disrupted trends. Among medical-only states, those that allowed home cultivation had 60% lower rates of EVALI than those that did not. Additionally, this one policy change made the odds of vaping as the primary form of consumption 40% lower, demonstrating that patients were ready and willing to switch from vaping to smoking home-grown cannabis once they were able. Acknowledging this data, the study’s authors called for states to consider initiating home cultivation policies.
In making suggestions for mitigating the future impact of EVALI, the study’s authors point to regulated products via legalization policies that would reduce users’ reliance on illegal, potentially tainted, products. Their conclusion supports a petition signed by over 800 industry leaders in 2019 focused on descheduling cannabis to address the vape crisis.
All in all, the study pointed to cannabis policies prioritizing legalization and access (particularly to more natural forms of cannabis like flower) as the most potentially effective method of combatting EVALI. As legalization efforts ramp up, experts hope to see an exponential decline in the occurrence of the condition.
Consuming alcohol heavily in young adulthood is associated with an increased likelihood of developing alcohol use disorder (AUD), the most widespread substance-related disorder worldwide. Research has already shed light on the effects of individual differences like alcohol sensitivity and cardiovascular responses in predicting binge drinking behaviors and progression to AUD. However, there remains a gap…
Kentucky is once again exploring medical cannabis legalization, D.C. made good on its expungement promises, and Minnesota okayed a psychedelic task force. Let’s dive into this week’s cannanews. Kentucky Inches Toward Medical Cannabis Legalization Earlier this week, Kentucky’s State Senate passed a new proposal that seeks to legalize medical cannabis in the state. Under the…
The people of Japan, a country renowned for its sushi cuisine scene, iconic Mount Fuji, and eye-catching cherry blossom trees, may soon have access to legal medicinal marijuana for intractable diseases. On Tuesday, January 24, several legislative bills were unveiled by the Japanese government. One of the proposed bills would amend the Cannabis Control Law…
Missouri is home to an estimated population of roughly 6 million residents. The state is popular for the agriculture industry, barbecue, and historic landmarks like the Gateway Arch. Missouri borders eight states and is a gateway to adventure in the land of legal cannabis. Six of the eight states surrounding Missouri have very strict cannabis…
Alternative medicine is becoming more widely acknowledged and practiced than ever before, opening the door for therapies like psychedelics to enter the world of mainstream healthcare. One psychedelic that’s been getting a whole lot of attention lately is psilocybin, an active ingredient in mushroom species that are often called “magic mushrooms.” Psilocybin is a naturally…
At one time, there was a sign coming into Las Vegas that read, “Don’t gamble with marijuana.” In Nevada, possession equals 20…
Maryland and Delaware are exploring their cannabis policies, a Texas representative introduced another decriminalization bill, and New Orleans okayed cannabis-infused seltzers. Let’s…
Who would have thought that cannabis cultivation could be Alaska’s biggest earner? Over the course of the next eight years, marijuana cultivation…