Medical cannabis: Making the switch from smoke to vape

Vaping medical cannabis

This is not just a piece of advice. It's a direction. Smoking medicinal cannabis flowers remains a prohibited way to administer it as outlined by government regulations when medical cannabis laws were introduced in 2018. No punishment has been specifically created for those found in breach of this. 

This prohibition remains in place for a number of reasons, primarily due to the well-known and documented clinical evidence that smoking has serious, harmful and irreversible repercussions. Smoking damage can reach the entire body, but the respiratory system is the most common victim. 

Prolonged use can spread to other organs, damage the immune system, cause multiple cancers and lead to limb amputation. In the face of this, smoking tobacco and tobacco sales currently remain legal, but the government has decided that prohibiting tobacco may now be phased out with an increase to the legal age of purchasing rising one year every year. This would mean anyone who is 14 years old now will never legally be able to buy a cigarette. 

Measures have been taken to reduce the number of people smoking, such as public smoking bans, raising the age of purchase from 16 to 18, restricting advertising, putting products behind a shutter so they are out of sight and introducing plain packaging to make them look less appealing to consumers. 

A recent online poll revealed that 75% of respondents are still smoking their medicine, which means they are not taking it in the directed way. 

At Releaf, we have considered the experience of patients switching to medical cannabis flowers for the first time and examined how this could be improved from day 1 of receiving their medication in the post. This is why Releaf+ subscribers will receive a welcome box with a handy Omura herbal vaporiser and flower sticks, ensuring the correct administration can commence. The welcome box additionally includes:

• A Releaf two-piece grinder.
• A glass jar.
• A Releaf Medical Cannabis Card can be used to carry all the information you require to prove you are a patient in the event you need to.

We want to ensure you have the best experience with Releaf on your legal medical cannabis journey.

Stoptober's history

Stoptober's roots spread back to the turn of the century. "No Smoking Day" was a public health campaign encouraging people with a tobacco smoking habit to try and quit. Everyone doing it simultaneously provided a way for people to have united moral support. 

Data generated between 2002-09 with the Smoking Toolkit Study indicated that nearly a quarter of a million people had attempted to stop smoking cost-effectively. Another interesting piece of information that the data produced was people's efforts to stop smoking dwindled as autumn set in. The idea to start a campaign focussed on encouraging people to keep trying at this time of the year was born. Stoptober is in its 11th year in the UK and has been replicated in New Zealand, the Netherlands and France. 

More data suggests that those who stop smoking for 28 days are five times more likely to give up for good. 

Smoking indoors and in work vehicles was banned on July 1st, 2007, as part of The Health Act 2006, although these bans had already been implemented in much of the UK. Pubs, bars and restaurants were given another year to adjust for the changes. 

Smoking medical cannabis is banned in the UK.

As pointed out earlier, smoking medical cannabis is still prohibited under the guidelines given to specialist doctors and clinics that prescribe cannabis-based medicinal products. 

There are several things that patients smoking cannabis should consider when it comes to choosing how to take their medicine. 

Smoking cannabis in a joint or spliff usually involves a cardboard roach at the mouth end to stop the ground herb from getting in the smoker's mouth. This is where the filter of a cigarette would normally go. Without this filter, the smoke inhaled will have more tar and microparticles that would normally be trapped by the filter's fibres, preventing them from entering their lungs. 

For those who say, "It's still medicine if it works", let me stop you there. Medicine is the diagnosis, treatment and prevention of disease; it is more than just about the presence of a medical compound or the effect that compound has. Treating one set of symptoms and knowingly causing another unrelated problem doesn't abide by the foundation of evidence-based medicine. 

Cannabis smoke contains carcinogenic compounds created when burnt. If they were included in the original preparation, there is no way it would qualify as a medicine. So, the notion that smoking cannabis is medicinal seems to fall short of the mark when it comes to ensuring that medicines do not contain harmful substances. The fact that medicinal compounds like cannabinoids, terpenes, et al. find their way into the bloodstream and have the same medicinal effects doesn't constitute a safe and effective medicine. 

Cannabis Smoke: Digging into the science a little deeper

Cannabis smoke under the scope isn't particularly healthy looking. It contains carcinogenic combustion products, including around 50% more benzoprene and 75% more benzanthracene (and more phenols, vinyl chlorides, nitrosamines, and reactive oxygen species) than cigarette smoke. However, there is little evidence to suggest that smoking cannabis pure leads to an increased risk of lung cancer, even though it can cause cellular damage. 

Other issues caused by cannabis smoke are lung and airway irritation, inflammation and hyperinflation. Persistent coughing can cause damage to the throat alveoli and increase the risk of throat, lung and bronchial infections. Patients with fragile bones have cracked a rib from coughing induced by smoking, which, believe it or not, can push air out of the lungs at around 50 mph!

A study published in 2022 has indicated that cannabis smokers have a higher risk of developing emphysema than tobacco smokers by 67% to 75%. This increase may be due to how cannabis is smoked (without a filter). Still, it's a risk that people can avoid by changing the method of administration away from smoking. 

The heat of cannabis smoke is also a risk factor that can inflame the lungs, and the risk of inhaling small parts of hot particulate matter is higher with unfiltered cannabis joints. Combined, they increase coughing and lung irritation. 

Smoking cannabis with tobacco? Read this now!

Many people's introduction to cannabis is in the form of a hand-rolled tobacco spliff with a sprinkle of cannabis mixed in. For those who previously didn't smoke, this culture introduces two habits. Those who want to continue using cannabis develop a nicotine addiction.

There are multiple myths that people tell themselves or use as excuses; this is nothing more than cognitive dissonance, though. You do not need a little bit of tobacco in your joint for it to burn (lots of people smoke pure without it extinguishing itself) - because you shouldn't be burning your cannabis in the first place! 

Taking your cannabis with nicotine can have detrimental effects on the control of your dosage regime. Nicotine's addictive nature encourages cannabis smokers to dose more frequently, but not because the body needs more cannabinoids; it is because the body is craving another nicotine hit. The mixing of the two confuses the body. 

Smoking tobacco with cannabis can present an extra set of problems often overlooked due to cultural normality. There are sincere harm reduction reasons behind encouraging patients to tackle their toking of combusted cannabis. Smoking tobacco is strongly linked to developing emphysema and lung cancer.

Not only do the same problems as above apply, but the danger of tobacco smoke is added, increasing the risk further. There are 70 known carcinogens found in tobacco smoke that patients can avoid, which don't need to threaten you when you are medicating with cannabis. Carbon monoxide, tar and toxic chemicals such as benzene, arsenic and formaldehyde; the damage caused by these chemicals reduces the amount of oxygen delivered to your organs. 

Smoking nicotine releases a number of hormones and neurotransmitters that cause their own set of responses. Adrenaline is the main chemical the body releases when nicotine is used. The brain also gets a release of dopamine 2.5 times greater than baseline levels, and it is thought that the combination of these two compounds contributes to nicotine's powerfully addictive properties. 

What are the benefits of switching to a vape from smoking?

Patients who give up smoking cannabis with tobacco notice that it is nicotine addiction, leading them to believe they need to use more cannabis and redo it more often. 

There is also a wider realisation of what the effects of THC are and the effects of nicotine. With nicotine increasing the amount of adrenaline in the body, it changes breathing and heart rate, more blood is sent to the brain and muscles, blood pressure increases, and it increases alertness. It also raises blood sugar levels, increasing energy. 

Vaping THC without nicotine will likely make patients feel the effects of THC a little more strongly. Research into the differences between smoking cannabis and vaping has shown that vaping has a greater bioavailability, meaning more will enter the bloodstream. In a test where participants took 25mg of THC either smoked or vaped, those who vaped had 14.4ng/ml of THC in their blood vs. 10.2ng/ml for those who smoked. 

This discovery proves that vaping is more effective than smoking and will lead to more cost-efficiency. Smoking also destroys 30% of THC before you inhale it. 

Patients who quit smoking tobacco find they use less cannabis, the cannabis they are using is effective, and they stop exposing their bodies to the harmful effects of combustion and nicotine. 

Now, you may find that nicotine benefits your life and how you function, which is absolutely fine. Nicotine can increase concentration and focus, but the release of beta-endorphin can also help inhibit pain. It might work out better for your health in the long run if you switch to another way of taking it, like patches, gum or vaping. Moving towards a separate mode of administration will allow you to feel the effects of each separately and allow you to monitor your use of each much more attentively. 

The advantages of vaping 

As we have already covered, vaping cannabis has a greater bioavailability than smoking while still benefiting from the rapid onset. Vaping also avoids burning 30 per cent of the THC and reduces exposure to harmful combustion chemicals. The burning end of a cigarette is between 500 and 700 degrees Celsius, but vaping allows you to control the temperature of the air and cannabinoids you inhale. 

The toxins in smoke paralyse the cilia, which are the tiny hairs responsible for cleaning mucus from your airways. Long-term exposure to smoke toxins destroys the cilia, making it harder for your lungs to clear mucus and other unwanted debris you may breathe in. 

Due to the terpene profile of different cannabis strains, it may be beneficial to alter the temperature of the vaporiser device to provide the most effective delivery - something you cannot control when smoking. People who recently quit smoking tobacco with cannabis report that the difference between strains is much more noticeable. 

A 2018 study in biological psychology tells us that tobacco smokers have a 20% reduction in CB1 receptors (the receptor that THC binds to) across all brain regions. Another study suggests that smoking cannabis with tobacco is linked to greater levels of anxiety and depression compared to using them separately. You may want to speak to your doctor if you are experiencing increased anxiety or depression and use tobacco. They can talk to you about ways to reduce your tobacco consumption to ensure you have the support you need.

Can CBD help you stop smoking?

Believe it or not, scientists have been acknowledging the effect of CBD on smoking for over a decade. 

A study in 2013 showed that smokers who wanted to quit tobacco smoked 40% less when taking CBD than those in a placebo-controlled group in the first week of trying. So CBD might be a helping hand for those looking to kick nicotine addiction, not just smoking. A very recent study published in March 2023 shows that 320mg of CBD taken orally helps reduce the anxiety and negative side effects of stopping nicotine use (through e-cigarettes). 

A separate study also carried out in 2023 indicated that CBD and its metabolite 7-OH-CBD inhibit nicotine metabolites in the liver, which may be why some studies have shown positive effects for reducing addiction and smoking cessation. 

Whilst CBD doesn't particularly affect dopamine levels, cannabinoids have been shown in animal studies to reduce adrenaline blood plasma levels. Nicotine is deceptive in creating the feeling of relaxation, but as soon as it wears off, the anxiety that it was masking may become heightened. CBD is, however, beneficial by lowering cortisol, so if you smoke to reduce stress, vaping or taking CBD orally may be more suitable for quelling anxiety. 

Other advice for helping to quit smoking

Take baby steps. It's much easier to tell someone to stop than to stop. The first step for those still taking tobacco is to separate your cannabis and tobacco. The next step is to slowly reduce the amount of tobacco you smoke each time or the number of times you smoke in a day. Consider the alternatives to smoking if nicotine helps you with some aspects of your life or if you find it difficult to break the addiction if you can stop smoking. With the UK banning disposable vapes by the end of the year, using a vape liquid with decreasing amounts of nicotine can be an effective aid in weaning yourself off. 

How do I get a medical cannabis prescription?

If you are reading this article and wondering how you can go about getting a medical cannabis prescription and becoming a legal patient, enter your details into our eligibility checker. With the details you provide, we can advise you on the first stage of eligibility in a matter of minutes. You can then book an appointment with one of our specialist consultant doctors, who will discuss your medical condition and decide if medical cannabis is a suitable option for you. 

Why you should speak to Releaf about medical cannabis

Cannabis-based medicinal products are much safer for your health than cannabis that is not prescribed. It exposes you to fewer risks than illicit cannabis sourced from an unregulated supply. Unregulated cannabis can often be contaminated with pesticides that, when smoked, are concentrated and become much more harmful and poisonous. In the worst-case scenario, pesticide exposure causes gastrointestinal issues, cancer and mental health disorders. Pesticides are often designed to be used on crops that are eaten, not smoked, and smoking allows them to enter into the bloodstream in larger amounts much faster than possible when ingested. So, if you are serious about looking after your health and using medical cannabis correctly, we would love to help you along your journey.