How You Use Cannabis Matters: Bongs Predicted the Most Health Effects in Young Adults | Research

The takeaway

An EMA study of 206 young adult cannabis users found that consumption method significantly predicted health outcomes, with bongs causing the most physical and psychological effects and sex differences emerging across methods.

Young adults choosing between cannabis consumption methods and healthcare providers counseling cannabis users.

Bongs predicted the most physical and psychological effects, while edibles predicted the fewest physical effects in females

What the researchers found

Bong use predicted significantly more physical and psychological health effects than other methods. Joint use was associated with more physical effects in males and more psychological effects in females. Edible use predicted fewer physical effects in females. Hand pipe use predicted more psychological effects in females. Effects varied significantly by both mode of use and sex.

Why it matters

As cannabis products diversify, understanding how different consumption methods affect users differently, and how those effects vary by sex, is essential for harm reduction messaging and clinical guidance.

The numbers in context

206 participants (62% female), 14-day EMA. Bongs: significantly more physical and psychological effects. Joints: more physical effects (males), more psychological effects (females). Edibles: fewer physical effects (females). Hand pipes: more psychological effects (females).

How the study worked

Ecological momentary assessment with 206 young adult post-secondary students (62% female) who regularly used cannabis. Participants completed two daily surveys on their phones for 14 days, reporting details of their most recent cannabis use and associated effects. Multilevel modeling analyzed mode-effect relationships.

What this study cannot tell us

Self-reported effects and consumption details. 14-day study period may not capture all patterns. Post-secondary students may not represent all young adult users. Could not control for dose across methods. EMA completion rates may vary.

How to read the evidence

Preliminary: EMA design captures real-world use but relies on self-report, with a moderate sample limited to post-secondary students.

When this study was published

2025 study.

The bigger picture

Most cannabis research treats all use the same way, but this study demonstrates that how you consume cannabis matters as much as how much you consume. This has implications for both harm reduction and regulation.

Questions still open

Why do bongs produce the most effects? Is it the larger doses typically consumed? Do sex differences in effects reflect biological differences or different use patterns? Should harm reduction messages be tailored by consumption method?

Common questions

Which way of using cannabis is safest?

This study found edibles predicted the fewest physical health effects (in females), while bongs predicted the most effects overall. However, "safest" depends on many factors including dose and individual response.

Do men and women experience cannabis differently?

Yes. This study found joints caused more physical effects in males but more psychological effects in females, and hand pipes affected females' psychological health more than males'.

Read the original research

Mode Matters: Investigating the Associations Between Mode of Cannabis Use and Self-Reported Physical and Psychological Effects.

Substance use & misuse, 60(14), 2244-2253

View on PubMed ↗Publisher’s paper ↗

Citation

MacDonald-Spracklin, Rachael; DeWolf, Darien; Thompson, Kara. (2025). Mode Matters: Investigating the Associations Between Mode of Cannabis Use and Self-Reported Physical and Psychological Effects.. Substance use & misuse, 60(14), 2244-2253. https://doi.org/10.1080/10826084.2025.2538733