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A Practical Guide to Smoking for Medical Cannabis Patients

Updated on July 6, 2011
Cannabis - Marijuana - Pot - Weed - Herb
Cannabis - Marijuana - Pot - Weed - Herb


Some of you may wonder, as you begin reading this, why I would want to give instructions for something that most cannabis users have known for so long they don't even remember having had to learn it. There are two reasons:

  1. Nowadays, people sometimes begin using marijuana for (gasp!) legitimate medical reasons. They haven't spent enough time around recreational users to absorb the knowledge some take for granted.
  2. Even long-time pot smokers sometimes (gasp again!) have imperfect smoking technique.

This hub is primarily intended to help medical marijuana patients who have never used marijuana recreationally, but may also be useful as a refresher on the art and science of cannabis consumption. I hope it will be a useful reference for those who need it.

There are lots of ways to smoke herb (I'm going to use some of the different terms for cannabis so you can get used to the lingo.) There are a lot of non-smoking ways to use your medicine, too, but I won't get into them here. We'll go through the best-known smoking devices and the essentials of smoking, with a few odd tidbits thrown in for good measure. Ready?

How smoky do you want your smoke to be?

Inhaling smoke can feel pretty harsh on your throat and lungs. According to one large-scale study, even the heaviest smokers of marijuana had the same risk of lung cancer as non-smokers...but that doesn't change the fact that it can feel harsh. Some people grow to enjoy the feeling (think about spicy food), but others go to great lengths to minimize the discomfort or perceived health risks involved.

This wide range of preferences has led to the creation of a wide variety of tools and smoking techniques. To find the ones that suit you the best, you may need to experiment a little. If you like gadgets, you're in for a treat! It's a great excuse to shop for some cool stuff.

The best-known way to smoke pot is to roll joints or blunts, which are both essentially cigarettes made with weed instead of tobacco. The difference is a matter of the type of wrapper used and the size of the cigarette. Joints have been used for a long time, while blunts have only gained widespread popularity over the last decade or so, mainly among younger smokers.

A joint is made by rolling up some cannabis in a special piece of paper called a “rolling paper.” The rolling paper is very thin and usually has a thin strip of adhesive along one edge, much like the adhesive strip on the flap of an envelope. The cannabis is broken or ground into fairly small pieces and rolled up into something that looks a lot like a cigarette. It's hard to get the herb to fill the cigarette all the way out to the ends, so both ends usually are tapered.

A blunt is really more akin to a cigar than a cigarette, because it is made by replacing the tobacco filling of a cigar with cannabis (you can also buy wrappers that simulate this effect without having to take apart a real cigar.) The wrapper is cut open from one end to the other, the tobacco inside is discarded, and the resulting wrapper is used in approximately the same way as a rolling paper

The rolling of joints and blunts are arts in and of themselves, and can take some time to master. The difficulty can vary a lot, depending on the methods and materials used, so don't worry if you have some trouble at first. Joints and blunts are often shared among several users, and there are usually one or two people in any group who roll them regularly.

Joints are smoked like cigarettes, except for two things:

  1. Joints are typically passed from person to person. This reduces the amount of material wasted between hits (puffs) when the joint burns and the smoke isn't inhaled by anyone. It also contributes to a sense of community and friendship, which many consider very important.
  2. A joint is rarely filtered, and is often smoked until only a tiny fragment, called a roach, is left. Toward the end, the joint is carefully pinched on one side between thumb and forefinger, and brought near to the user's lips. At this point, it's not necessary to put one's lips against the paper. The user draws air from inside and around the joint, so all of the smoke coming from both ends of the joint ends up in her lungs.

Smoking joints is as easy as smoking cigarettes, and, like cigarettes, joints can be rolled in advance. People sometimes like the convenience of being able to stop and light up wherever they need to (within reason). A blunt is used in pretty much the same way as a joint.

Smoking pot begins with partially burning it, and many chemicals are created in this process that don't exist in the original plant material. The effects of inhaling this new mixture are noticeably different from the effects of inhaling unburned components of marijuana. Sometimes the new chemicals are helpful for a medical condition, sometimes they are harmful.

Also, marijuana smoke from a joint or blunt is typically pretty hot. This can be irritating to the throat and lungs, even if there is no long-term damage. People who find the hot smoke unacceptable typically find another method of smoking (or perhaps eat their cannabis instead).

Another very common, tried-and-true smoking device is the pipe. Pipes come in a staggering array of sizes and shapes, but they all work by the same basic principle as tobacco pipes. Your herb goes into the bowl at one end and you draw air from the other end, touching a flame to the herb to light it as you begin to inhale.

One feature on marijuana pipes you won't find on tobacco pipes is the carburetor, know colloquially as a “carb.” A carb is nothing more than a strategically placed hole in the pipe on or near the end with the bowl. When using a carb, keep it plugged up with a finger until your herb is well-lit. Then just uncover it in time to clear all of the smoke out of the pipe before you're done inhaling. If the smoke coming through the pipe is too harsh for you, letting a little fresh air through the carb earlier, while you draw the smoke in, will greatly improve your comfort level. You will need to take more hits of this thinner smoke, though, to get whatever effect you're seeking. Remember that some pipes don't have carbs at all.

The design of a particular pipe can also affect the properties of the smoke it produces. A long, thin pipe will tend to cool the smoke more, while other designs might place the smoker's mouth less than an inch from the burning herb—usually a scorching experience. Some are made of wood, others metal, others glass, and so on. Like joints and blunts, pipes can be very convenient, but they aren't disposable. Some people may not want to carry evidence of using cannabis with them, or may not want the extra weight, or just may not feel like carrying it around. On the other hand, pipes offer a huge variety of aesthetic qualities, and many are pieces of art as well as smoking implements.

For a smoother, cooler feeling with thick, potent smoke, the bong is a tried-and-true champion of THC delivery. A bong, also known as a waterpipe, is a special kind of pipe in which the smoke coming from the bowl must bubble through a reservoir of water before it is drawn into a smoker's lungs. As with regular pipes, there is an impressive variety of style, function, and price among waterpipes. Note that some business owners will not sell a bong to you unless you refer to it as a waterpipe. My best explanation for this is that the fear of being arrested for selling “drug paraphernalia” seems to elicit responses like this from otherwise sensible business people. (Read about Tommy Chong's arrest and sentencing for sale of “drug paraphernalia” to understand what people are so afraid of.)

Using a bong is a little different than using a pipe. For example, the bowl is often further from your mouth and the bong is heavier than a pipe is. You need to grip the bong a little differently, and it may take a little trial and error to figure out how to simultaneously hold the bong up, operate the carb, and light the bowl with your cigarette lighter. Using matches is not recommended, but has certainly can be done. Bongs also tend to have attributes specific to each model, such as a mouthpiece with an unusual shape or size.

Finally, there is a relatively new kind of device, called a vaporizer, that fundamentally changes the nature of marijuana inhalation. A vaporizer is similar to a pipe or bong in that it uses heat to extract active chemicals (called cannabinoids) into the air being inhaled by the patient. There is an important difference, though; a vaporizer does not heat the herb to the temperature required for combustion. In other words, nothing is being burned. Instead, air is heated to a temperature sufficient to boil the beneficial components and drawn through a chamber containing the medicine. These components then enter the air stream and flow into the lungs. Whereas smoking involves the creation of new chemicals in the combustion process, some of them harmful, vaporizing only carries the naturally occurring chemicals into your body. The subjective effects of vaporizing are often described as “cleaner.”

If you don't like the idea of smoking but don't want to eat your medicine, vaporizers might be just what the doctor ordered. Most vaporizers are available for purchase directly through the internet or by mail. A smaller selection should be for sale at you local smoke shop. Do some research, choose a high-quality vaporizer, and you'll soon get a feel for this unique method of cannabinoid delivery.

With this glimpse into the array of implements available for smoking trees (yes, another slang term for your new medicine), you're ready to choose a technique and obtain whatever device you need to get started. This choice can be a little bit intimidating, but the owners of most pipe stores (often called “head shops” or “smoke shops”) are more than happy to talk to you about what you want and help you get started with a good pipe. Spend as much or as little time, money, and patience as you want. Most cannabis users buy more than one smoking device, so don't get too preoccupied with finding the one perfect choice. You can always go back to the store for another round of shopping.

Cannabis grows like a weed because it is one - the most useful weed you will ever see
Cannabis grows like a weed because it is one - the most useful weed you will ever see

The science and art of smoking cannabis

You have jumped through legal hoops, you've chosen and purchased tools for smoking your medicine, and obtained the medicine you need. You're probably excited to get started. You need the medicine, which is why you're reading this in the first place. You may feel some ambivalence, too. That's natural for anyone considering a new medicine of any kind, let alone one that's been demonized in the popular media for eighty years. Don't worry, though. As you probably know by now, not one person has ever died from smoking too much pot. Not a single person among the millions and millions who have used it throughout history. If you think the advantages will outweigh the disadvantages, there's no reason to worry. If you change your mind later, you can simply stop smoking cannabis. The herb's non-addictive nature means you'll probably feel just fine when you do.

So here's how it's done. You light your lighter, put the mouthpiece (or end of the joint, etc.) to your lips, cover the carb if there is one, and inhale. It's really quite simple. Now, getting everything you possibly can out of your herb is something that may take years to perfect, but that's OK—there'll be plenty of time for that. There are a few things you should know though, things that may not be obvious at first.

First, you have to hold the lighter in a position that allows the flame to be drawn into the bowl or onto the end of your joint, blunt, etc. for long enough to light the weed inside without burning your fingers. Experiment with different angles and locations until you can do so with confidence.

You also need to inhale through the end of your pipe, etc., strongly enough to pull the flame into the medicine. If you don't do this at the right time, the flame will do nothing except heat up whatever else it comes in contact with. Make sure that's not your body, hair, or clothing. 'Nuff said.

It's also very important to draw the smoke into your lungs and hold it there for at least ten seconds. Most users hold the smoke in as long as they comfortably can. This allows the smoke in the bronchi and bronchioles to diffuse into the air in the alveoli, which are the tiny air sacks at the ends of the bronchioles. The air in the alveoli does not move except for this diffusion or mixing of air. It is therefore inefficient to inhale and then quickly exhale smoke or vapor. Some time is needed for the mixing to take place. It is the alveoli that allow the cannabinoids to pass into the bloodstream and then take effect as intended. To sum it up again: hold the smoke in.

A little bit of coughing is normal, but if you find yourself having long, uncontrollable coughing fits every time you inhale smoke, you may be taking in too much smoke or the smoke may be too thick for you. Leaving the carb open for more of the time or partially breaking the seal your lips make with your smoking device should mix more fresh air in with the smoke and reduce the urge to cough. As with other skills, trial and error is the way to find the perfect technique for you. Pay attention to what your body tells you. 

Some notes about dosage

A comfortable and effective dosage is very dependent on your own body chemistry. Again using trial and error, you will get a feel for the right amount to use to treat your condition. Sometimes the doctor who recommends cannabis to you will give you some direction, but smoking weed isn't an exact science. Controlling dosage is ultimately up to you.

Using your past experience as a guide, take the number of tokes (inhalations) that seem like the minimum you might need. Because the effects of inhaled smoke can take 20 minutes or so to reach their full strength, it's a good idea to wait this long after your last hit (another term for an inhalation) before deciding you need another. An excessive dose of marijuana isn't dangerous, but can be very uncomfortable. It's bound to happen sometimes—when it does, just relax as well as you can and ride it out. A little time is all it takes to feel better.

First time users, note carefully: you will need more herb to achieve an effect the first few times you use it and less herb on subsequent occasions. This is an important and unusual quality of cannabis; most users experience reverse tolerance when they first begin smoking it. In fact, it's likely you'll feel nothing at all the first time or two. This is normal and nothing to worry about.

When you first begin to feel the effects from cannabis, you may be using a relatively large amount to achieve those effects. As you continue to use it, beware that you may begin to need significantly less each time. If so, you will need to adjust your dosage downwards. The best way to remain comfortable during the adjustment is to take a hit or two at the beginning of your session and wait for 15-30 minutes before taking another. Be patient, relax, and have another hit only after the last one has had time to reach its maximum effect. This is what the doctors and scientists refer to as “titrating” your dose. In a short while, it will become second nature.

Cannabis users, please take a moment to describe your smoking skills

How much experience do you have smoking Cannabis?

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Finally, remember that all medicinal cannabis is not created equal. Whenever you get new medicine, test the waters first with a small dose. Some is much stronger than others, and the effects of some strains can feel very different from the effects of others.  

Cannabis is a wonderful and complex medicine. Treat it with respect and you will most likely find it to be quite enjoyable. Explore the different flavors, psychological and physical effects. There is an endless variety of medicine to choose from, each type with its own character. Do some research. Become a connoisseur. Stay safe and enjoy all that your new herbal medicine has to offer.

Click thumbnail to view full-size
Cannabis sativa can be a beautiful plant!Cannabis flowering top - buds in the makingSome marijuana has a blue-green colorCannabis in a modern outdoor gardenCannabis getting ready for harvest
Cannabis sativa can be a beautiful plant!
Cannabis sativa can be a beautiful plant!
Cannabis flowering top - buds in the making
Cannabis flowering top - buds in the making
Some marijuana has a blue-green color
Some marijuana has a blue-green color
Cannabis in a modern outdoor garden
Cannabis in a modern outdoor garden
Cannabis getting ready for harvest
Cannabis getting ready for harvest


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    • MThacker profile image

      Michael Thacker 

      6 years ago from Fort Worth, Tx, USA

      Very informative and useful. Vaporization definitely the healthiest way to go as far as smoking goes and the comment up top from geyeser was pointless and like you stated had nothing to do with the main focus of your article; he's just a cannabis hater! lol

    • weedprices profile image


      6 years ago

      Nice guide man! Very well made.

    • profile image

      lee gong 

      7 years ago

      Very helpful. I'm new to the culture. Thanks!

    • imarijuana profile image


      7 years ago

      I really like your hub check mine out!

    • Sterling Sage profile imageAUTHOR

      Sterling Sage 

      8 years ago from California

      Kari, I appreciate the feedback.

      Every new cannabis smoker has to learn their technique somewhere. Most "rebel" types first try smoking pot for recreational purposes in a drug-culture context, with plenty of knowledgeable peers for teachers.

      I know there are others, though, who have never seen the substance before, let alone smoked it. These kinds of patients may not know who to ask for directions. By writing this hub, I hope I've made the process a little less intimidating and a little more accessible for them.

    • Kari Winchester profile image

      Kari Herreman 

      8 years ago from Ontario, California

      Informative! I could have used this when I first started smoking medical cannabis! I had to have friends show me how to even hold a pipe, lol.

    • Sterling Sage profile imageAUTHOR

      Sterling Sage 

      8 years ago from California

      Thanks for the comment, Tina! I agree that there appear to be some benefits to ingesting Cannabis rather than smoking it. Vaporization is certainly worth considering too, as others have noted.

    • gr82bme profile image


      8 years ago from USA

      Sterling, I have also been researching the use of medical marijuana. Many patients that use medical marijuana say they now have a better quality of life. These are Aids, arthritis, cancer, MS, and many more that are saying the use of the drugs they were on were destroying their body. The pain meds. are very addictive and some even said they turned to alcohol to medicate.

      Ingesting marijuana is safer and the effects last longer then smoking. Plus its better for you. Patients have reported getting a better nights sleep after ingesting marijuana. I have a hub on Cooking with medical Marijuana and on that hub there are links to some powerful research in the use of Medical Marijuana.

      I hope you will check it out. I would like to link to your Hub Page. voted up!



    • Sterling Sage profile imageAUTHOR

      Sterling Sage 

      9 years ago from California

      Thanks, Lynda! Can you post the link to your article?

    • Lynda Gary profile image

      Lynda Gary 

      9 years ago

      On schizophrenia: I once had a client who's schizophrenia was induced by an injury he sustained from using a printing press. Are printing presses "bad"? No. The fact is, schizophrenia is one of those unique mental illnesses that lie dormant in some people, and then is triggered by odd, unpredictable, experiences. The benefits to society, however, outweigh the RARE risk of inducing schizophrenia -- something that will NOT happen if the person doesn't have an underlying mental disease to begin with!

      On smoking: Yes, it's dangerous. It IS bad for the lungs. Cannabis smoking is LESS dangerous than cigarettes, but it still poses a risk. That's why the American Medical Association supports the use of medicinal marijuana via a vaporizer. A vaporizer produces a smokeless vapor that does NOT harm the lungs.

      Thanks for this hub! I'm linking it to my similar article.

    • profile image


      9 years ago

      i have smoked marijuana for 20 years, I used to have asthma, but now i dont the only breathing problems i have are a slight couph in the early morning. And although it is not addictive, people do tend to become dependant on it, making it look addictive.

    • Sterling Sage profile imageAUTHOR

      Sterling Sage 

      9 years ago from California


      For some patients, cannabis works best when smoked. For example, an AIDS patient once told me that it was only the joint over his toilet that kept him from throwing up every time he took his anti-retroviral medicines. If he had used another route of administration, it would not have taken effect fast enough to do any good. His life literally depended on smoking cannabis.

      And no need to apologize. I welcome opposing points of view. Thanks for the read.

    • profile image


      9 years ago

      I am sorry Sterling, whatever benefit marijuana/cannabis may offer but one thing is very well established that SMOKING IS HARMFUL doesn't matter what you smoke.

      A simple experiment you can do. Smoke on to any fruit regularly (5 minutes twice a day) in a closed container and see the changes.

      Lungs are one of the most vascular organs having the maximum sensitivity for any change in its millieu and whenever you will smoke it will respond the same you as to cigarette or cannabis or marijuana.

      So, its my sincere request to advocate non smoking alternative therapeutic advice.

      I apologise if my comment hurt you.

    • Phrenism profile image


      9 years ago

      I'm sorry your relative spontaneously generated schizophrenia and was a regular user of cannabis, but schizophrenia often appears randomly regardless of cannabis use with about the same percentage rates as non-smokers, so it shows that it merely happens sooner if there is actually any effect at all.

      ..And it cures cancer

    • Neil Sperling profile image

      Neil Sperling 

      10 years ago from Port Dover Ontario Canada

      Goes great in chicken soup - just pop in a handful in place of Parsley flakes - a large handful is best... LOL

    • Sterling Sage profile imageAUTHOR

      Sterling Sage 

      10 years ago from California


      There are lots of vaporizers available, and some are quite reasonably priced. I've even seen a few hand-held models that use an ordinary cigarette lighter as a heat source.

      Almost anyone who wants too can vaporize her herbs if she wants to. Medical cannabis patients would do well to keep a vaporizer around.

    • explorer9360 profile image


      10 years ago

      I want a vaporizor!

    • Sterling Sage profile imageAUTHOR

      Sterling Sage 

      10 years ago from California


      Sorry you feel that way about it. I'm not trying to argue the benefits of legalization or anything like that here, though. It's just about technique for those who need to know (and by definition, they are not recreational users).

      I do encourage anyone considering a new medical treatment to discuss it with her doctor first. You can consider this a reminder of the importance of knowing the facts before making a decision.

    • profile image


      10 years ago


      Read you link. Just goes to show what one can do with statistics... make any valid statement become invalid just because we didn't like what they had to say.

      I had a relative which developed schizophrenia from regular consumption of marijuana; with zero family history and no other influences for its onset... the marijuana-schizo link seems pretty convincing to me.

      I guess I would have thought better of your hub had you chosen to provide comment to both the use of the drug and mention of the potential dangers associated with that use. I have no issue with people smoking dope, or utilising other avenues of outlet, provided that they are made aware of the risks that they are taking. I find it irresponsible (like the way the media acts) when someone gives all the good stuff and fails to mention the risks.

    • Sterling Sage profile imageAUTHOR

      Sterling Sage 

      10 years ago from California


      I didn't discuss the issue you raised because my focus in this hub is not to replace the advice of anyone's physician. My goal is to provide information for those who have already decided to use marijuana and have seen a doctor to decide if it's a good idea.

      Besides, it appears unlikely that marijuana increases one's risk of schizophrenia. The pronouncements to the contrary are based on faulty reasoning.

    • Sterling Sage profile imageAUTHOR

      Sterling Sage 

      10 years ago from California

      Tatjana, thank you for the thoughts. It's nice to hear from you too!

    • Tatjana-Mihaela profile image


      10 years ago from Zadar, CROATIA

      Hi, Sterling! Nice to see you again!

      Very interesting Hub and beautiful pics...

      Some people are too sensitive so their fears and negative imagination are much stronger on cannabis.

      From the another side, some people can benefit from moderate use....

    • profile image


      10 years ago

      How come you didn't warn your readers about the link between Marijuana use and Schizophrenia?


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