Violence Against Women Who Inject Drugs.

Although there are many ways to consume cannabis, using a vaporizer or “vaping” is a relatively new phenomenon, introduced to the US market in 2007 (). There are various reasons why individuals elect to vape, compared to traditional methods of consuming substances. For example, reasons include taste, pleasure, and curiosity (). Primarily, individuals report they enjoy vaping due to the pleasant taste the vape flavors provide and due to the pleasurable effect vaping brings (relaxation, socialization with peers, and relief from boredom) (). Additionally, individuals vape out of curiosity of the mechanism to explore its use with cannabis or other substances (). People who prefer vaping cannabis report they like this method because it produces less odor and is more discreet than smoking (). The electronic vaporizer heats the cannabis to a temperature at which it is aerosolized but does not burn. Vaping occurs with dry cannabis as well as with e-cigarettes that use cannabis oil, which are produced in many flavors (). Vaping cannabis can include using a variety of products including oils, dabs, and waxes, which can be 4 to 30 times more potent in THC concentration than dried leaves (; ).Vaping is an increasingly popular way to consume cannabis to achieve the effects of the substance (), especially among youth (). In a survey of 8th, 10th and 12th grade students, the latter reported nearly double the prevalence of vaping cannabis between 2018 and 2019 (7.5% vs. 14%, respectively (). For example, in a sample of 5 high schools ( = 3,847) in Connecticut, 5.4% of respondents reported ever vaping cannabis (). Peters and colleagues () found that lifetime vaporized cannabis use was reported by 10.5% of tenth-grade students, while 4.9% reported past 30-day vaping use. Eggers and colleagues () found that lifetime prevalence of cannabis use with electronic vaporizer pens was 3.4% among middle school students and 11.5% among high school students. Using the Monitoring the Future data from 2017 and 2019, Keyes and colleagues found faster increases in adolescents’ frequent cannabis vaping, defined as vaping cannabis at least six times in the previous 30 days, compared to rates among adolescents who vape cannabis occasionally or less than six times in the past 30 days (). Among high school seniors, Palamar and colleagues found that the incidence of frequent heavy use of vaping cannabis, defined as using cannabis at least 10 times in the previous 30 days, increased from 2.1% in 2018 to 4.9% in 2019 (). Earlier research concluded that vaping was less harmful than smoking cannabis because the vaporized substance had fewer carcinogens (; ). However, more recent studies have found mixed reviews on the level of toxins and chemicals that are present in vaporized cannabis (; ). With the legalization of cannabis in numerous states for both medical and recreational use, mixed messages on the potential harms of cannabis use in the media can give youth and adults misleading information regarding the potential for negative consequences of using cannabis. Potential harms include the development of cannabis use disorder (; ) and excessive impairment (). While harms specific to the vaping route of administration are relatively rare, e-cigarette or vaping associated lung injury (EVALI) has been documented by the CDC as resulting in 2,897 cases of which 68 cases have resulted in death (; ). Additional harms, especially among youth, may include impairments in brain development and difficulties with school achievement and social functioning (; ; ). Furthermore, high potency cannabis has been linked to mental health deterioration, including anxiety, psychosis, hallucinations, catatonia, and rapid onset of paranoid delusions (; ).