E-cigarettes, once thought to be a safer alternative to cigarettes and a tool for helping smokers quit, are drawing criticisms after a spike in vaping-related hospitalizations. While most people who use e-cigarettes as their preferred method of nicotine delivery experience little to no detrimental health effects, the consequences of vaping can be serious. A cluster of hospitalizations in Wisconsin, Illinois, and Montana, in which patients experienced severe lung damage, has been linked to vaping. Although an investigation is ongoing, and potential other causes have yet to be determined, these hospitalizations, where symptoms included coughing, weight loss, and significant breathing difficulties, seem to be connected only by the fact that the patients in question vaped. One patient, an 18 year old named Chance Ammirata, even experienced a collapsed lung, which he attributed to vaping.

More research needs to be done to determine exactly what could cause vaping to lead to hospitalization. But the presence of THC oil cartridges, with which users can get the same high they would from smoking marijuana, are a potential risk factor. 26-year old Dylan Nelson, for instance, had to be placed in a medically-induced coma after vaping using a THC cartridge he bought from a friend. The oil in the cartridge, according to Nelson, was watered-down and discolored, suggesting it may have been tampered with.

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For most people, the only way to get a THC cartridge is through a friend or a drug dealer.

Ingestion of THC via vaping has become a popular alternative to smoking marijuana. But a number of factors present concerns about the safety of this method of getting high.

For one, THC remains illegal in most states. That means for most people, the only way to get a THC cartridge is through a friend or a drug dealer. In this way, it can be difficult for users to ascertain the legitimacy of the products they are purchasing; whereas users in states where marijuana is legal can buy the product directly from a dispensary, which sources their cartridges directly from the manufacturer, users in other states have to rely on their own sense of judgment to determine the safety of their products. In California, 7 cases of hospitalizations from illicit cannabis vape cartridges have been reported, though the actual number of such cartridges is certainly much higher. And while no deaths have been associated with consuming marijuana, THC cartridges that have been tampered with nearly killed at least 2 individuals.

Another risk factor associated with THC cartridges is the quantity of drug that can be delivered. Relative to smoking marijuana, each inhale of a vape pen with a THC cartridge (or with a nicotine cartridge) attached administers a large amount of the drug. And because nothing is being ignited, users can continue to inhale the drug indefinitely, as doing so requires only that the users hold down a button. Furthermore, vape pens with THC cartridges attached can be mistaken for e-cigarettes, causing individuals to accidentally get high when they meant to consume nicotine. In states where THC has been legalized, hospitalizations resulting from accidental use of marijuana have increased.

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Marijuana use during adolescence has been linked with lower IQ, higher chances of developing mental illnesses such as schizophrenia, and decreased life satisfaction.

Additionally, the long term effects of vaping both nicotine and THC products are unknown due to the simple fact that they have only existed for a few years. While conventional wisdom holds that the lack of smoke and carcinogens present in these products means that they’re safe, they can contain a number of other harmful chemicals, including heavy metals such as nickel, tin, and lead, and flavoring such as diacetyl, which has been linked to lung disease. The batteries that power these devices, particularly ones that are cheaply manufactured, also have the potential to ignite or explode, causing physical injury to the user.

Vape products are particularly appealing to young people, who are at greater risk of addiction and other detrimental health effects due to the fact that their brains are still developing. While research on the effects of THC on the developing brain is somewhat limited, marijuana use during adolescence has been linked with lower IQ, higher chances of developing mental illnesses such as schizophrenia, and decreased life satisfaction. As with all recreational drugs, including alcohol, refraining from using vape products of any type is recommended for avoiding negative health consequences, from short-term impairment to addiction to life-threatening conditions.