Dr Farrah Kheradmand on How Marijuana Legalization Impacts Research on e-Cigarettes, Vapes

Farrah Kheradmand, MD, elaborates on the effects of marijuana legalization and increased recreational use on research into electronic cigarettes.

What we do know is that people don't just use marijuana vapes or nicotine e-cigarettes, said Farrah Kheradmand, MD, a professor of medicine-pulmonary at Baylor College of Medicine and a staff physician at the Houston Veterans Affairs (VA) Medical Center.


As more states legalize marijuana and it is smoked more often in electronic pens, how does that factor into your research on nicotine and e-cigarettes?

What we do know is that people don't just use one or the other. In fact, most people start vaping nicotine with flavors or without flavors, and then they add other layers. They've become more sophisticated, especially in youth. Because then they get into, well, "You can get some from the black market most often," and they can actually fill in the cartridges with whatever they just purchased.

The unfortunate part of it is that there was an epidemic of lung injury, associated death, and hospitalization. Several people needed lung transplantation. Now we do know that some of those chemicals that were added in, in addition to the THC [tetrahydrocannabinol] product, were toxic to the lungs. Now we're just basically taking someone who thinks vaping is safe, and [they say], "Hey, let's just do more recreational things,: and they're adding to it. Where they're getting their THC from matters, and what other chemicals are in there to make the THC product thicker, to make it appear that it actually is very concentrated [matters]. Those are some of the compounds that we're focusing on to understand how they impact, again, induced lung injury, and again, to try to understand and reverse the process to save the lungs.

Overall, what do we know about e-cigarette use at this point in time?

We know from lots of human and animal studies that, unlike what the industry is trying to promote, vaping is not a safe alternative to cigarette smoking. What I'd like to emphasize is that the carriers of nicotine are highly dangerous to the normal process [of] the body, the normal physiology of human lungs; they're highly toxic to that. Once you get to a point where you disrupt this cycle—about recycling of surfactant—once you're disrupting that process, then you bring in a new chemical to it, being what THC has been dissolved in, and all other compounds, then you are at a much higher danger of making the whole process come to a complete halt. Meaning that now you not only have poisoned the immune response to viral and bacterial pathogens, but now you actually are disrupting their healing process, meaning the alveolar type 2 cells, your stem cells inside the lung that need to repair the lung—you're actually injuring that. So that's how we see consequences of acute lung injury, and that can have really devastating consequences for anyone, including the youth.

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