Why would you smoke cannabis?
Imagine smoking. Inhale… Exhale… Big inhale! Cough, cough, cough! Lungs filled with smoke, tar, toxins.
We have been warned off about smoking for years, mainly from our collective knowledge of the risks of smoking tobacco. But we know smoking cannabis brandishes harms, too. 
Looking at Canada, among survey respondents who used cannabis in the past year, the majority used cannabis flower. Despite over half (53%) being exposed to health warnings, increasing their knowledge of the harms related to cannabis use, the majority continued to smoke. Indeed, smoking (84%) was the most common method of consumption in Canada among non-medical users. While not identical, there are similar trends for Canadian medical users (using on average 1.5 gram/day cannabis flower).  And, indeed, this use profile is mirrored among respondents in previous ‘use’ surveys. 
So, why are people not vaporizing?
Is it the cost? Is accessing and using a vaporizer prohibitive? Is it people not being used to vaporizing technology? Is it faster to roll and smoke a joint? 
The benefits of vaporizing cannabis
We know that the use of a high-quality vaporizer device avoids the respiratory disadvantages of smoking. 
A vaporizing medical device, compared to smoking cannabis, dramatically lowers concentrations of toxic compounds such as carbon monoxide, ammonia and polyaromatic carbohydrates (PACs). Compared to smoking, higher therapeutic levels of THC and consistent, reproducible THC extraction and delivery is possible.  
It has been established that inhalation via a vaporizer is an efficient route of administration. The vapour is quickly absorbed by the lungs, resulting in measurable cannabinoid serum levels rapidly (reaching Tmax within minutes). 
The rapid onset of effects of vaporized and inhaled cannabinoids allows easier titration of the dose based upon symptom severity, tolerability and avoidance of side-effects.  While fully standardised, pharmaceutical-quality cannabis flos enables the administration of an exact dose – assured dose composition and dose repeatability. It also means it is free of contaminants such as microbes, pesticides, heavy metals and other toxic compounds. From a patient safety perspective, these qualities make the vapour safer for inhalation into the lungs.
Over the past years, more and more patients have vaporized cannabis flos without reports of serious adverse reactions. It is now time to start exploring ways to move patients away from smoking toward less harmful modes of administration.
Given patients seek a reliable, affordable and portable vaporizer for administering cannabis flos, perhaps more attention is required here?
Is adept, well-timed policy the way forward?
Future thinking – policy angles
Given patients indicate a preference for vaporizers, sensible policy and practical education might be the way to usher in positive change.
With regard to administration, the future policy must be clear and obvious. For example, in Germany, Australia, New Zealand, and The Netherlands smoking cannabis flos is not permitted and/or actively discouraged. The clinical guidelines only support cannabis flos for inhalation administered by vaporization. These types of policies need support from the health sector, industry, and must achieve buy-in from patients and their careers.
Some other approaches might include:
- Setting a positive regulatory environment, focusing on and enabling rapid developments in the vaporizer industry. The aim is to usher in vaporizers which are more affordable, portable, easy to use, environmentally and consumer friendly.
- Ensuring that a blanket ban on inhalation is not pushed into law. Excluding quality vaporizer devices from the market would be nonsensical. It would:
- Eliminate their valid use in hospitals and hospices, rest-homes, and home settings.
- Have implications for administration options; limiting therapeutic options and prescriber-patient choice.
- Confine administration to oral dosing only (i.e. excluding the inhalation option).
Policy focused to support education is another, including:
- Educating prescribers, pharmacists and patients to be aware of the differences between ‘vaping cannabinoids’ and ‘vaporising cannabis flos’, and fully understand why smoking should be avoided.
- Educating the consumer (i.e. patients) on the benefits of using a vaporizer, compared with smoking. This requires really clever social-advertising – getting people to change, often embedded, behaviours and the accepted culture of smoking a joint.
- Educating the consumer (i.e. patients) on what makes a good vaporizer – what quality aspects to look for.
For more on administration, see the article The risks of vaping cannabis.
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 When administering pharmaceutical quality cannabis flos.
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 Tmax: the time it takes to reach the maximum concentration (Cmax) of an exogenous compound or drug in the plasma or a tissue after a dose is administered.
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