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In the days and weeks leading up to stay-in-place orders and lockdowns, legal cannabis sales spiked.
Some studies and anecdotal reports suggest marijuana can help people cope with anxiety, which is being felt deeply across the world as the coronavirus pandemic continues.
But lung health experts warn that smoking marijuana regularly could increase a person's risk of contracting COVID-19, and also having more severe symptoms and complications from the disease, given evidence on tobacco and COVID-19, and what we already know about how heavy marijuana-smoking can impact the lungs.
Although there's no data on marijuana use and COVID-19 patients, marijuana smokers - particularly ones who combine cannabis with tobacco - should be wary of their habits because of existing data on coronavirus patients in Italy and China, according to Dr. Barry J. Make, a pulmonologist at National Jewish Health.
"From China and Italy, we see people who developed COVID-19 and had underlying lung disease, [they] have more complications and die more often," Make said. "So this is the perfect time to stop smoking."
Preliminary CDC data found that chronic lung diseases including asthma, chronic obstructive pulmonary disease or COPD, and emphysema, were common underlying conditions in hospitalized patients in the US.
The CDC was able to analyze 7,162 laboratory-confirmed COVID-19 cases and found that 656 of them, or 9.2%, reported having a chronic lung condition.
Smoking marijuana could also make a person's COVID-19 symptoms worse compared to a non-smoker, Dr. Panagis Galiatsatos, a pulmonologist and national spokesperson for the American Lung Association, told Insider.
Galiatsatos said that people who smoke marijuana regularly are more likely to experience severe COVID-19 symptoms because evidence suggests marijuana smoking can cause cells in the lungs to die.
These cells typically promote germ removal and immune system response, so having fewer of them could lead to chronic health problems like respiratory infections.
"A good portion of the world will be infected by [the coronavirus], but the level of severity of symptoms is going to depend on so many variables, from genetic components to just your overall preexisting conditions," Galiatsatos said.
"From my standpoint, meshing [together] all of the variables that put in things that are not air into your lungs, I would view them all kind of in the same category," he said. "The best and most efficient data we have is about tobacco and its impact on COVID-19," he said. "For e-cigarette and marijuana use, the data isn't as robustly collected," so right now marijuana should be put in the same category as tobacco in order to draw risk-related conclusions about the substance.
"We know cigarettes and marijuana both cause cellular toxicity and changes in cellular metabolism and cellular behavior, so that would be a biologically plausible explanation to say if you got an infection from [COVID-19], you're likely to have more dire symptoms," like shortness of breath and pneumonia, if you smoke.
For that reason, proponents of marijuana, like Erik Altieri, the executive director of National Organization for the Reform of Marijuana Laws, say that smokeless methods like edibles and tinctures could be a smart idea for the time being.
"Individuals should consider that consuming hot smoke from combusted plant material can be an irritant to the respiratory system, especially for those currently showing symptoms," Altieri told Rolling Stone.
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Make warns that, for those who do not have a medical prescription, everyone should be cautious about using the drug, particularly during the coronavirus pandemic, even if you don't have troubling breathing or a cough.
"The lung disease you usually get from smoking and vaping and marijuana doesn't occur until you've smoked for a number of years and it very slowly develops," Make said. "A lot of lung disease related to these inhalants are silent until they're very far advanced."
Galiatsatos recommends that people find alternative coping mechanisms to treat anxiety during the pandemic.
"If you get the infection and you have good, healthy lungs that aren't being combated every day by toxins, whether it's from inhaled marijuana or inhaled combustible cigarettes or inhaled electronic cigarettes, you're allowing your lungs to be at the best capacity they can to try and fight off this infection," Galiatsatos said.
"I would plead with everyone to do what you can in a time like this. I know I'm a lung doctor and this is coming off very biased, but this virus will destroy this organ if it finds any susceptibility, so please keep that in mind."
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