April 6 (UPI) -- Severe lung illnesses caused by vaping are more common in states where consumers do not have legal access to recreational marijuana dispensaries, an analysis published Monday by JAMA Network Open suggests.
A spate of e-cigarette- or vaping-associated lung injury, or EVALI, in 2019 was associated with use of marijuana-based products and more than half of the documented cases occurred in people 25 years of age and younger, according to the U.S. Centers for Disease Control and Prevention.
An increasing number of teens are using marijuana vaping and "edible" products, according to a separate study published Monday in JAMA Pediatrics, making the safety and availability of such products of concern to parents.
"Our results are suggestive that those in recreational marijuana states may be less likely to purchase illegal marijuana products on the black market," Dr. Alex Hollingsworth, assistant professor in the O'Neill School of Public and Environmental Affairs at Indiana University and co-author of the JAMA Network Open study, told UPI.
By late fall of last year, more than 2,500 cases of EVALI were reported nationally, with nearly 50 deaths associated with the condition, which caused significant lung damage and breathing difficulties. .
Although the specific cause of EVALI remains unknown, most patients diagnosed with the condition have reported using e-cigarettes containing tetrahydrocannabinol, or THC, the primary psychoactive component of marijuana. It is believed that black-market THC products, those purchased illegally, caused the EVALI outbreak in the United States, according to the CDC.
For their analysis, Hollingsworth and his colleagues reviewed data on reported EVALI cases by state against estimates of the prevalence of e-cigarette use by state in 2017, based on the Behavioral Risk Factor Surveillance System and estimates of state populations in 2017 from the Surveillance, Epidemiology, and End Results database.
States that have legalized recreational marijuana had an average of 1.7 EVALI cases per million population, while there were 8.8 cases per million population in states that have legalized medical marijuana. The authors found that there were 8.1 EVALI cases per million population in states where marijuana use was still prohibited across the board.
The assessment also revealed that recreational marijuana states have 7.1 fewer cases of EVALI per million population than medical marijuana states and 6.4 fewer cases per million population than prohibition states.
Meanwhile, the number of teens who smoke marijuana decreased from 2015 to 2018, while use of edible and vaping products went up by roughly 25 percent and 33 percent, according to the analysis of data on 12th-graders by Dr. Megan E. Patrick, of the Institute for Translational Research in Children's Mental Health at the University of Minnesota. The data was collected as part of the Monitoring the Future study.
The percentage of 12th-graders who reported using edibles increased from 32 percent in 2015 to nearly 40 percent in 2018, while the percentage of those who vaped the drug rose from 26 percent to 34 percent over the same period.
"I think it's important for parents to know that marijuana use is changing, and adolescents are more often vaping or consuming edibles than they have in the past," Patrick told UPI. "These types of marijuana use are easier to conceal than smoking, so it's important be aware of these trends."