Florida's Premier Medical Cannabis Clinic

Less Vaping Illness in Legal Marijuana States

Less Vaping Illness

Vape pens have been in the news recently, and not in a good way. After several years of trending strong in both the recreational and medical marijuana communities, in the fall of 1999 these devices were identified as the cause of a respiratory disorder known as EVALI, as in E-cigarette or Vaping Associated Lung Injury. By early 2020, nearly 3,000 hospitalizations and deaths were attributed to EVALI, and the American Medical Association had called for a ban on e-cigarette and vaping products.

But as it turns out, banning marijuana vape pens may not be the best solution, and a more recent research letter published in the Journal of the American Medical Association reports that vaping-related respiratory illnesses actually decreases in areas where marijuana is legal. While this information may seem counter-intuitive, it makes sense based on what we now know about the causes of  EVALI.


Preliminary reporting by the FDA showed that a significant portion of the vaping products sampled by their labs contained cutting agents and additives.

Most significant was the news that:

  • 50% of the THC products have been found to contain vitamin E acetate as a diluent (the concentration of vitamin E acetate determined in a subset of these samples ranged from 23% to 88%)
  • 29% of the THC products have been found to contain another diluent such as medium-chain triglycerides

The report also identified a strong correlation between these additives and cases of EVALI, reporting that:

  • 81% of cases included products with vitamin E acetate as a diluent
  • 32% included products with aliphatic esters as diluent (e.g., triglycerides)
  • 9% included products with polyethylene glycol as a diluent


As CannaMD previously reported, the presence of vitamin E acetate is often associated with vaping products produced by unlicensed facilities and obtained from illegal sources. Given the understanding that the uses of vitamin E acetate to dilute or stretch THC content in unregulated vaping products may be the problem, it is not surprising to learn that cases of EVALI are far more prevalent in states where medical and recreational marijuana are still illegal.

In response to this finding, the authors of the Journal of the American Medical Association research letter citing these statistics noted:

The data suggest that EVALI cases were concentrated in states where consumers do not have legal access to recreational marijuana dispensaries.

One possible inference from our results is that the presence of legal markets for marijuana has helped mitigate or may be protective against EVALI.

Additionally, the study’s lead author is quoted by the news site MedPageToday saying that the team’s findings are:

…consistent with the hypothesis that people have a demand for marijuana products, and in states where they don’t have access to them in this regulatory fashion, they end up purchasing them elsewhere.


Currently, there is no national standard for testing the content of marijuana vaping products. As former head of the FDA Scott Gottlieb wrote in the Wall Street Journal:

Federal agencies exert little oversight, and regulation is left to a patchwork of inadequate state agencies. The weak state bodies sanction the adoption of unsafe practices such as vaping concentrates, while allowing an illegal market in cannabis to flourish.

This lack of consistent testing and labeling underscores the importance of obtaining vaping products from known and trusted sources. This is why the products provided through Florida’s medical marijuana treatment centers, or dispensaries, are laboratory tested, do not contain cutting agents such as coconut (MCT) oil, PG, VG, PEG or vitamin E acetate, and instead use cannabis-derived terpenes to reduce the viscosity of cannabis extracts for vaping.

To protect your health, only purchase legal, regulated cannabis products.

Get Your Medical Marijuana Card

Before purchasing cannabis from a medical marijuana treatment center or dispensary, Florida patients must first qualify for a medical marijuana certification; CannaMD‘s board certified doctors provide qualified patients with the state-required recommendation to complete this process.

To get started, call CannaMD at (855) 420-9170 or complete a quick online application today!

Find Out If You Qualify

You may be eligible for medical marijuana!

To stay up-to-date with the latest studies and legal regulations surrounding medical marijuana treatment, be sure to follow CannaMD on Facebook and sign up for our newsletter, below!

Join 80k+ Subscribers!

Get updates on more posts like this!

Author Bio


  1. I also wonder about use of locally grown marijuana that is then hung in barns or other enclosures to dry. Pretty sure that in tobacco growing states (Kentucky – actually a Commonwealth) and others, cut plants are often hung to cure in old tobacco barns. Those barns are also home to bats, rats, insects, animal wastes, other possible sources of bacteria, viruses, and perhaps residuals of agricultural chemicals. Has there been any research on this possibility? And then there are the homegrown operators.

    1. Hi Mark! Research has primarily focused on legal/state-authorized dispensaries (which have strict grow requirements, which would preclude the barn scenario); however, it’s an interesting question! We’ll let you know if we come across anything 🙂

  2. There is a growing body of evidence that CBD can cause increases in intraoccular pressure (IOP) and result in or aggravate glaucoma. THC may mitigate but some medical marijuana users want to use only or mostly CBD. This seems to have been the case for me – elevation of IOP resulting from use of CBD. I am and remain a licensed legal user of medical marijuana, and support its use for medical conditions as well as occasionally and judiciously for recreation. Just a disclaimer that I am not an opponent of appropriate uses of cannabis.

  3. Ok Guys – I hear you but unfortunately my story contradicts your findings. I’ve been smoking weed often for at least 40 years. I started vaping about two years ago when Trulieve and Surterra introduced this method to South Florida. I vaped daily but I was still a moderate user.
    Then, this past March I got a terrible case of Bronchitis that put me in the hospital for several days. I was better for a couple of weeks and then in April a got a serious case of pneumonia and I was hospitalized for several days again. My lungs were seriously infected both times & I still have some damage. Since I never smoked cigarettes my doctors concluded the vaping was the cause of both events. BTW – I tested negative for Covid-19.
    Obviously, I’m not smoking anymore but I do edibles that are pretty good.
    I want you and your readers to know about this and think twice before vaping.
    I also hope you will do more research to find out just how serious this problem is and put out more warnings about the damage vaping can cause.
    I look forward to getting a reply from you. Please let me know if I can do anything to help.
    Thank you.

    1. Hi Bruce! Thank you for taking the time to share your story. We’re so sorry to hear about your health problems! This particular post is based on reports from the Journal of the American Medical Association, one of the most respected peer-reviewed research journals in the country. While every patient experience is different, we wanted to share these important findings from leading researchers. We’ll be sure to post more studies as they become available!

Join the discussion

Your email address will not be published. All fields are required.


Stay informed with the CannaMD newsletter!

Related Post

Get a medical marijuana certification in Florida

Tag Cloud

Feedback from our readers is very important and helps us provide quality articles. Please don’t be shy, leave a comment.

If you have a topic you would like us to cover in our blog or you are interested in writing guest posts please contact us for more information.

Medical Cannabis Brief

Pin It on Pinterest

Share This