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Far Fewer Incidences Of Vaping Illness Reported In Legal Cannabis States According To Study

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In the midst of the coronavirus pandemic, many people forget about a previous health crisis that was sweeping across the globe and was particularly bad in North America – the vaping crisis.

For many weeks reports were popping up of people experiencing illnesses after consuming vape pen cartridges, and in some cases, the suffering individuals died, which is extremely unfortunate. Cannabis opponents pounced on the crisis and pointed to it as ‘proof’ that cannabis reform was failing.

Cannabis advocates were quick to point out that a vast majority of the vape pen cartridges involved were unregulated, and that the best way to address the crisis was via more cannabis regulation, and not less, which is essentially what cannabis opponents were calling for.

A recent press release from NORML provides further proof that cannabis advocates are right. See the press release from NORML below:

Incidences of the vaping-related lung illness EVALI (e-cigarette or vaping product use-associated lung injury) are primarily concentrated to jurisdictions where adult-use cannabis consumption is prohibited, according to data published in the Journal of the American Medical Association (JAMA) Network Open.

Commenting on the findings, NORML Executive Director Erik Altieri said, “These findings come as little surprise. In jurisdictions where cannabis is legally regulated, consumers gravitate toward the above-ground retail marketplace where they can access lab-tested products manufactured by licensed businesses.” He added, “Just like alcohol prohibition gave rise to the illicit production of dangerous ‘bathtub gin,’ marijuana prohibition provides bad actors, not licensed businesses, the opportunity to fulfill consumers’ demand – sometimes with tragic results.”

According to the US Centers for Disease Control and Prevention, nearly 3,000 people have sought hospitalization because of the illness, which peaked last September, and nearly 70 people died as a result of it. In November, the CDC publicly identified vitamin E acetate – a diluting agent sometimes present in counterfeit, unregulated vape pen products – as a primarily “culprit” in the outbreak.

Writing on Monday in the journal JAMA Network Open, researchers affiliated with Indiana University reported that last year’s sudden outbreak of EVALI cases was not driven by either state-level differences or prevalence in e-cigarette use. Rather, they reported that cases “were concentrated in states where consumers do not have legal access to recreational marijuana dispensaries. … One possible inference from our results is that the presence of legal markets for marijuana has helped mitigate or may be protective against EVALI.”

A previous analysis of EVALI prevalence in legal cannabis markets versus illegal markets by drew a similar conclusion.

In a statement to the online news site, the study’s lead author said that the team’s findings are “consistent with the hypothesis that people have demand for marijuana products, and in states where they don’t have access to them in this regulatory fashion, they end up purchasing them elsewhere.”

Full text of the study, “Association of state marijuana legalization policies for medical and recreational use with vaping-associated lung disease,” appears in JAMA Network Open. An accompanying editorial, “Marijuana legislation and electronic cigarette- or vaping-associated lung injury,” also appears online here.


NORML’s mission is to move public opinion sufficiently to legalize the responsible use of marijuana by adults, and to serve as an advocate for consumers to assure they have access to high-quality marijuana that is safe, convenient, and affordable.

Find out more at and read our factsheets on the most common misconceptions and myths regarding reform efforts around the country at

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