Humberto Choi, MD: The Misunderstanding of Non-Cigarette Products


From medical marijuana to vape devices, there seems to be a divide in defining what's legal for use, and what's actually beneficial for users.

In the final portion of his interview with MD Magazine® while the CHEST 2019 Annual Meeting in New Orleans, Humberto Choi, MD, a pulmonologist with the Cleveland Clinic, provided a take-home message for users of vaping products and medical marijuana.

While the 2 legalized and marketed products serve entirely different purposes from the perspective of the public, to Choi, they’re shrouded in misconception. Simply put, he advises users consider whether something being legalized truly makes it beneficial—especially for lung health.

MD Mag: Is there a need to provide answers to vaping’s effect on lung health soon?

Choi: I definitely understand that people want an answer fast, that they want an answer now. But unfortunately, it will take time, and we just have to be very careful with our message on the information that we have. We want to be as precise as possible when we give an answer, because we don't want to meet mislead anyone.

And something that is a misconception is about this this idea of the word itself: vaping. What people are inhaling are not vapors—it’s really an aerosol. I think the CDC mentions that a few times in their website, because vapor is just the gas from liquid or from something that is solid. And aerosol is just a gas that is mixed with particles and sometimes water, and other things. They're not just inhaling a gas, they’re inhaling gas with a bunch of other things.

And that is probably that one of the reasons for all these lung injuries.

MD Mag: Do we fully understand the respiratory effects of medical marijuana, and is it being properly regulated?

Choi: I think there's a lot of confusion about that. I don't think it's clear what are all the benefits of what people call medical marijuana. So far, there's nothing medical about it. Just like any medication that we will prescribe, we would like to know if it's really effective, at which dose, what side effects it can cause. I don't think we have that understanding for a lot of the products that already being offered.

And a big confusion that is made for marijuana specifically is the process of legalization. Just because a product is legal, it doesn't mean that it's healthy or that or that is beneficial. And I think that confusion, a lot of times, lies on that a concept.

I've been asked a few times about vaping and marijuana. ‘Well, marijuana is legal so maybe I can use that.’ Well, a product that is legal doesn't mean it is healthy—it doesn't mean that it’s not harmful. And I think there’s confusion about that that idea right now.

And a case study that we are bringing here to this conference is about a young man who acquired a medical card with a purpose to obtain marijuana in legal ways—but really for recreational use. There is no scientific data to support smoking marijuana for clinical use ,and I think that confusion may lead to that.

So we’re report a case that someone obtained a card in legal ways, but it definitely caused harm to his lungs as a young man—a teenager who had multiple pneumothoraces because of that, which is a known complication from smoking. But there's no nothing medical about that, just the problem that developed in his lungs.

So I think this is something that the public needs to know: that something that is legal doesn't mean that it is healthy. It doesn't mean that it’s beneficial.

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