Do carts or dab pens hurt the lungs at all?

Yes, carts and dab pens definitely have the potential to hurt your lungs. While they are often marketed as a safer alternative to smoking, research over the past several years has clearly shown that vaping cannabis or THC oil is not harmless and comes with distinct respiratory risks.

🫁 The Most Serious Risk: EVALI

The most immediate and severe risk associated with vaping THC (the primary psychoactive compound in cannabis) is a condition called EVALI (E-cigarette or Vaping Product Use-Associated Lung Injury).

What it is: EVALI is a severe and sometimes life-threatening respiratory illness that first came to national attention in 2019. It can cause symptoms like cough, shortness of breath, chest pain, fever, and fatigue, rapidly progressing to respiratory failure.

How common is it? Between 2019 and 2020, over 2,800 people were hospitalized with EVALI in the United States, and there were at least 68 confirmed deaths. The majority of those affected were young people (under 35 years old) and male.

The Cause: The main culprit identified in most EVALI cases was vitamin E acetate, an oil sometimes used as a thickening agent in black-market THC cartridges. When heated and inhaled, this oil coats the lungs and causes severe inflammation. This is a stark example of how unregulated products can cause catastrophic lung injury.

Other Respiratory Harms

Beyond the acute risk of EVALI, using vape carts and dab pens is linked to a range of other negative effects on the respiratory system.

Chronic Respiratory Symptoms: Studies show that people who vape are more likely to report chronic symptoms like a daily cough, phlegm production, and bronchitis. This is true for both nicotine and cannabis vapes.

"Popcorn Lung" Risk: Some flavoring chemicals used in vape products, particularly diacetyl, have been linked to a serious and irreversible condition called bronchiolitis obliterans, nicknamed "popcorn lung," which causes permanent scarring in the small airways of the lungs.

Lipoid Pneumonia: Inhaling the oily concentrates used in dab pens and some carts can lead to lipoid pneumonia, a rare condition where fatty particles accumulate in the lungs, causing inflammation and making it difficult to breathe.

Exacerbation of Asthma: Vaping is known to worsen symptoms in people with asthma. It can increase the frequency of asthma attacks and lead to more severe, even life-threatening, exacerbations.

⚖️ Is Vaping Better Than Smoking?

This is a key question. While vaping may expose you to fewer of the combustion-related toxins found in smoke from a joint or blunt, it is not safe.

Reduced Exposure to Some Toxins: Vaping does not involve burning plant material, so it significantly reduces your exposure to the carcinogenic tar and carbon monoxide produced by smoking. This is why some researchers suggest it may be a form of "harm reduction" for people already smoking cannabis.

A Distinct Set of Risks: However, "reduced exposure" is not the same as "safe." Vaping introduces a different set of risks, including the potential for severe acute lung injury (EVALI) from additives like vitamin E acetate, which is not a concern with smoking flower. A 2025 study from UC Davis found that while cigarette smoke caused the highest level of inflammatory molecules in the breath, vaping still caused significant changes in the airways, indicating stress and inflammation.

🛡️ How to Reduce Your Risks

If you choose to use these products, you can take steps to minimize your risk of serious lung injury.

Avoid Black Market Products: The most critical step is to only purchase products from licensed, legal dispensaries. The EVALI outbreak was primarily driven by contaminated black-market THC cartridges.

Check for Additives: Be aware of what's in the oil. Avoid any cartridge that lists vitamin E acetate, medium-chain triglycerides (MCT) oil, or other thickening oils as ingredients.

Control Your Temperature: If using a device that allows it, use lower heat settings. Overheating the coil can cause it to break down and release heavy metals like lead and nickel into the vapor.

Listen to Your Body: The most important rule is to pay attention to how you feel. If you develop a persistent cough, chest pain, shortness of breath, nausea, or fever after vaping, stop using the product immediately and see a doctor.

In short, while vaping cannabis may be less harmful than smoking it, it is far from harmless. The oils, additives, and byproducts of heating can cause significant and sometimes severe damage to your lungs.