To Smoke or Not to Smoke…Is Not the Question!

Photo by Gabriele Stravinskaite on UnSplash
Cindy Kleh 19 May 2020

Smoke Less, Smoke Smarter – Harm Reduction Beats Hard Choices

Most cannabis tokers will admit that it’s not the best idea to compromise their lung health by smoking weed, especially when a novel virus is ripping through communities around the globe. This virus has killed thousands of humans by silently invading their nose and throat, then flooding their lungs or causing major organ failure. 


There are alternative methods for consuming cannabis, each with its pros and cons. There are delicious edibles ranging from gummy bears and dark chocolate truffles to sumptuous pasta dishes, but they take a while to prepare and to kick in. 

Making edibles at home requires patience and precision in dosing. The cannabis must already be in a concentrated and decarboxylated state before going through the actual food preparation. 


Transdermal patches enter the bloodstream by penetrating the surface of the skin. Patches have a high bioavailability, and can release THC and/or CBD in a steady dose over many hours or even days without extreme mind-altering effects, but they may be missing the full spectrum of terpenes and other rare cannabinoids found in the whole plant (read the label). 

CBD patches are great for inflammation and can be placed on specific body parts, but they can’t be grown in a garden nor made at home, so they may be on the pricey side ($15-20 each). For those without a MMJ license or who don’t reside in a recreationally legal state, THC patches are not a viable option.  

Salves, massage oils, bath salts and lotions containing cannabis are also site specific, with relief possible in minutes and lasting for hours. Since topicals only affect

the first three layers of skin, the drug will not enter the bloodstream and get a patient “high.” Although they must be reapplied every few hours, they are great for skin disorders, sore muscles and joints, bug bites, wounds, and arthritis.  

The best thing about topicals, is that they can be made at home with very basic (preferably organic) ingredients, but the cannabinoids must first be decarboxylated to convert the major phytocannabinoids into “active” molecular forms that yield the medicinal benefits of the plant. 

“Growing and crafting your own medicine is as therapeutic as the medicine itself,” stated Jessilyn Dolan, RN and co-founder of NurseGrown Organics. “It can encourage us to take a more active role in our own health, bringing us closer to nature and further away from pharmaceuticals. Plus, as an herbalist, I love the synergy of all the possible and amazing plant combinations.”

Dolan is a cannabis nurse herbalist, specializing in cannabis therapeutics, opioid, substance use, and mental health disorders. She works at the University of Vermont as a research nurse and has completed the University of Vermont’s Cannabis Science and Medicine Professional Certificate program; Dolan is a member of the American Cannabis Nurses Association, founded the Vermont Cannabis Nurses Association and co-owns NurseGrown Organics. 

Dolan, a licensed hemp farmer and cannabis caregiver for medical marijuana, has been cultivating and crafting medicinal herbs for decades. She is also a Certified Massage Therapist with advanced training in acupuncture and Traditional Chinese Medicine, Craniosacral Therapy, and Reiki. She is a birth worker, labor doula trainer, and maternal child health nurse educator. 

Vaporizing Cannabis

Vaping can eliminate the smoke and can be a healthier alternative to pipes and bongs, but the method of consumption and the quality of cannabis products are key to vaping safely. 

Vaping Carts

How safe are vape pens? It’s a question worth asking, even if experts are still debating on the answer. Inhaling smoke – pot, tobacco or another substance — is definitely bad for lung health according to the American Lung Association. In fact, inhaling anything besides air into the lungs is not exactly healthy. 

Although the long term effects are still not known, many will point out that vaping oil is easier on your lungs than inhaling resiny pipe smoke or cigarettes as long as the cartridge or concentrate comes from a trusted, organic source without any added oils (especially Vitamin E acetate), flavors, or chemicals. 

Aside from folks who process their own oil using their own sterile machines, can anyone know for sure what has been added or contaminated in the black market or even in the legal markets?  

“Many medical professionals are encouraging vaping flower rather than cartridges or the typical combustion of smoking cannabis,” Dolan explained. “Knowing the source of your flower and how it is grown can be one of the best and easiest ways to protect your health while consuming cannabis.”

“As far as cartridges, there are many questions you would want to ask to be sure it is high quality and safe. How is it grown? Organic or conventional?  How is it processed? With hydrocarbons and chemicals or a simple rosin press? Is it a whole plant, or more of an isolated THC concentrate with added terpenes? What other additives could possibly have been added to the oil to make it less viscous? Has it been full-panel lab-tested for both potency and purity? Where was the cartridge itself manufactured?”

“Those are just a few questions I encourage patients to learn more about before choosing what to put into their lungs. It is difficult to find those answers in enough detail for me to feel comfortable using a vaping cartridge or recommending them to a patient.” 

Because a vast portion of the cannabis industry is still unregulated, many manufacturers do what they please when it comes to producing and marketing their products. 

Like cigarettes, it could take many years to discover the long-term effects of cartridge vaping on human lungs. Many chemicals used to make the cannabis oil less viscous and more usable, such as propylene glycol, are deemed safe by the FDA, but they haven’t been clinically tested for direct human inhalation. 

Most cannabis users remain understandably cautious about vape pens, especially since a recent outbreak of severe lung disease was found to be linked to the cartridges. Because a vast portion of the cannabis industry is still unregulated, many manufacturers do what they please when it comes to producing and marketing their products. 

And then there are the negative environmental impacts of cartridges, including the fact that they’re not recyclable and contain heavy metals, plastic, glass, wire, and other contaminants which could leach into soil and water supplies. 


Vaporizers provide more certainty about exactly what is going into your respiratory system. They can range in size from large hookahs to pocket-size devices, and they work by heating flower or concentrate to a lower level than combustion, delivering all of the flavor and goodness without the toxins, carbon monoxide, and particulate matter inhaled with smoke. Switching to a vaporizer can relieve “smoker’s cough,” and improve respiratory function in just a few weeks.

A Trade Off

But some just prefer the complex flavors and simple joys of smoking flower. Others prefer smoking because it delivers the needed medical effects immediately. In some cases, the harmful side effects of smoking can, for some, be weighed against the benefits.

“If smoking helps you, let’s see if we can help you smoke less and/or smoke more safely. It’s not a concrete, black-and-white thing.”

Dolan cited a few examples: A pregnant woman who is having severe morning sickness and is in danger of a miscarriage due to continual vomiting and/or a pregnancy complication known as hyperemesis gravidarum; a Veteran who suffers from PTSD and/or panic attacks, or has chronic or acute pain flare ups and needs immediate relief; a person in recovery who is responsibly medicating while working hard to stay away from more harmful drugs or prescribed pharmaceuticals; a cancer patient who needs help with keeping food down throughout their course of treatment; an older patient who is having difficulty sleeping, wakes up in the middle of the night and needs a quick return to sleep.

“There shouldn’t be shaming from the medical or herbal communities about combusting cannabis.”

“If smoking helps you, let’s see if we can help you smoke less and/or smoke more safely. It’s not a concrete, black-and-white thing. There shouldn’t be shaming from the medical or herbal communities about combusting cannabis. If patients are not comfortable being completely open with their providers, they might refrain from telling the truth about their choices, and that’s going backwards. It’s about harm reduction, not abstinence. We need to meet patients where they’re at.” 

Bogart That Joint!

Among the usual cannabis habits that Dolan would like to see changed are smoking rituals involving shared joints, blunts, and bongs. The puff-and-pass customs are among the greatest social pleasures of the plant, but for now, don’t share with friends or family. Pathogens can remain on these implements, and sharing the remnants of the last person’s exhalation is really not a good idea. Smoke together, but sit apart and don’t pass. 

Clean That Damn Bong!

One of the easiest ways to smoke healthier is to keep bongs and pipes clean and clear of resins, ash, and contaminants. The biofilm that collects on top of old bong water, even 24-hour-old water, is the perfect medium for colonies of microbes, yeast, mold, and mildew, as well as harmful pathogens like streptococcus and E. coli that can go right into the lungs. 

Dolan recommends sterilizing bongs and pipes daily, stressing that any amount of added cleaning is better than none. But she recommends avoiding harsh chemicals that can leave residues, and being mindful of the environmental impact. She also cautions using smoking devices that may have plastic or petra chemicals. “Investing in proper equipment is an important piece of medical consumption.”

“People are surprised when they realize that, as a nurse, I am not going to lecture them on smoking or tell them that they need to change everything about their cannabis consumption. I talk to them about how they are consuming, and give them ideas on how to make it a bit safer, and hopefully more economical and efficacious for them.”

Like drinking Louis XIV cognac in a plastic sippy cup, smoking fine weed in a dirty bong cheapens the experience. 

A clean piece also allows the best flavors and fragrances to come through, giving prime bud the expression and enjoyment it deserves. Like drinking Louis XIV cognac in a plastic sippy cup, smoking fine weed in a dirty bong cheapens the experience. 

Lab-Tested for Purity

Regardless of what method of consumption is chosen, it is of utmost importance that the cannabis flower or concentrate is third-party tested to make sure there are no contaminants such as pesticides, heavy metals, mycotoxins, bacteria, or residual solvents from processing. A grower could use only organic products and methods, but the soil could contain heavy metals and/or pesticides from previous uses.

Third-party testing means the product has been tested in an independent laboratory that has no connection with the grower, manufacturer, company or consumer who might have a financial stake in the test results. Purity testing ensures consumer safety and product transparency.

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