Combustible Marijuana Use and Legalization

Many people may associate the use of marijuana with smoking a joint or smoking it out of a pipe of some sort. These sorts of ingestion are forms of combustible marijuana use, which is not as good for lung health as eating an edible or inhaling vapor. An argument is being proposed that for marijuana to ever be legalized nationally, it would come with a limitation on combustible marijuana use due to the adverse health effects. Do you think it is a contradiction to make combustible marijuana use illegal, but allow combustible tobacco use?

Eight US states, the District of Columbia, and the country of Uruguay have recently legalized the recreational use of marijuana, with Canada and more US states poised to do the same. The new laws include limits on youth access, operation of motor vehicles when using, and high-volume purchases or possession. However, none of the laws consider which kinds of marijuana products should and should not be legally sold.

While we take no position on the overall desirability of marijuana legalization, we propose here that policy makers in favor of it consider only permitting the sale of tetrahydrocannabinol (THC) extracts intended for vaporization or eating, and prohibiting combustible marijuana product sales. While implemented laws allow growing of marijuana for personal use, the policy we propose here would prohibit only the sale of marijuana cigarettes and their makings—flowers, stems, and seeds—to discourage their commercialization and mass production.

Those crafting marijuana laws can draw upon lessons learned about the harms of combusted tobacco and the smoking control policies that followed. Given what we already know about the health hazards of combusted marijuana and the difficulty of controlling the sale of commercially established products, policy makers should capitalize on this opportunity to create a legal marijuana market that mitigates potentially significant harms associated with inhaling combusted marijuana while still facilitating desired benefits of recreational marijuana.

The trend toward marijuana liberalization has grown since the mid-1990s to most recently encompass recreational use. By 2018, more than 50 million Americans 21 or older will live in states with access to legal recreational marijuana. Proponents of legalization argue that it reduces the high social costs of criminal law enforcement, an ineffective deterrent to use, the burdens of which fall disproportionately on racial minorities. Creating a legal market for marijuana also facilitates taxes on sales, the revenue from which may be used for public benefit. Legalization, moreover, increases access to a drug less prone to dependence than alcohol or tobacco for therapeutic and pleasure-seeking purposes. Public support for legal marijuana access has risen three-fold in the United States since the 1970s to reach 60 percent in 2016. Likewise, in other countries such as New Zealand, Canada, and France, the majority of the public say they favor legalization of marijuana sales. As momentum to broaden marijuana access builds, policy maker focus ought to prioritize ways to reduce potential harms of marijuana products.

Alongside recreational marijuana use liberalization, policy interventions designed to limit tobacco smoking have proliferated, based on what we have learned about the harms of combusted tobacco—both for the user and those exposed second-hand. This apparent policy divergence from marijuana legalization presents an opportunity for those crafting marijuana policy to learn from the tobacco-smoking experience. After all, both products involve psycho-active substances that can be delivered to the bloodstream in multiple ways. Combustible marijuana likely poses similar risks to those of combustible tobacco, while vaporizing or eating marijuana products offers a “cleaner” delivery mechanism. Why repeat the devastating public health harms of smoking tobacco when policy makers can reasonably mitigate similar consequences of smoking marijuana?

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