The cause of vaping lung disease was identified back in August but the Centers for Disease Control and Prevention (CDC) apparently needed an additional four months confirm this fact. The CDC has now identified vitamin E acetate as the culprit. Just as importantly, the CDC did not find vitamin E in any of the 197 nicotine vaping products that they tested.
The CDC also noted that lung injuries associated with the use of vitamin E in black market THC cartridges are on the decline.
In 51 samples of bronchoalveolar-lavage (BAL) fluids from patients suffering from vaping related lung disease, 48 tested positive for vitamin E acetate. Another 47 of the patients tested positive for THC.
This “breaking” vitamin E news follows hot on the heels of the CDC’s 2019 Youth Tobacco Survey, which attempted to determine Why Kids Vape. They found that curiosity was the primary motivation and social contacts second. Flavors finished a distant third, nearly tied with vape tricks. These two stories combine to destroy the two pillars of the proposed national vape flavor ban. Just last week, the minimum age for purchasing e-cigs was raised to 21.
The CDC’s findings on vitamin E acetate were reported in the New England Journal of Medicine. In a fine example of burying the lede, CDC researchers failed to find a single nicotine ejuice sample that was contaminated with vitamin E acetate.
The NEJM study explained why vitamin E contamination was proven not to be an issue with nicotine vaping products:
“Pure THC oil has a viscosity like that of vitamin E acetate. Cutting THC oil with vitamin E acetate has been reported to be common in the illicit market.9-11 The FDA reports that most case-associated THC product fluids contain vitamin E acetate, at an average concentration of 50% by weight, ranging from 23 to 88%.8 By contrast, the FDA detected no vitamin E acetate in 197 case-associated nicotine products analyzed to date. The viscosity of vitamin E acetate makes it undesirable as an additive to nicotine solutions; the propylene glycol and vegetable glycerin in nicotine solutions create a fluid with a much lower viscosity than that of vitamin E acetate.”Centers for Disease Control, " Vitamin E Acetate in Bronchoalveolar-Lavage Fluid Associated with EVALI", 12/20/2019
Vitamin E Acetate Identified In August
Leafly Magazine identified the cause of vaping lung disease in August and reputable manufacturers of cannabis cartridges had expressed concern over the introduction of vitamin E as a cutting agent even earlier. The New York Department of Health noted that vitamin E acetate was the likely culprit way back on September 5, 2019.
Unfortunately, a fixation on the unrelated teen vaping epidemic resulted in a muddled and confusing response that conflated commercially available nicotine delivery systems with the THC cartridges which were responsible for the actual disease outbreak.
The term e-cigarette was used to describe both legal nicotine products and THC cartridge pens, which rely on entirely different "juice formulations." In defense of the CDC, this distinction was noted in their report. Nicotine ejuices are composed of propylene glycol and vegetable glycerin. Vitamin E is simply too thick, and dangerous, to be included in a time tested formula that has been used billions of times of the last decade.
As reported by NPR, the sharp spike in lung disease hospitalizations pointed to a single culprit and commercially available nicotine products were not associated with any of the incidents.
Do not expect the retraction and clarification of vaping lung illness to get the column space that the headlines did this fall. The damage has been done. It is nearly impossible to unring the bell of fear.
Dr. Anne Schuchat, a deputy director at the CDC, stated “We are confident that vitamin E acetate is strongly linked.”
The careless reporting of vaping lung disease set in motion a chain of events that threatens to eliminate the vaping flavors that adults prefer from the US market. To stay abreast of the legal status of vapes in your state, check out our resource page on Vape Ban Laws by State.
The CDC’s announcement does not take the form of a mea culpa and loses much of its impact when their website still has the headline “Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products.”
Why the CDC is incapable of adding a clarifying title or description to this important matter remains a mystery. If their job is to protect citizens and control disease, shouldn’t they describe health threats in a way that is logical and makes it clear what they are talking about.
The headline of the CDC’s food safety warnings about Romaine lettuce and eColi are not titled “Outbreak of E. Coli Infections Linked to Vegetables.” Nor do they blithely cast suspicion on all produce for months on end before quietly announcing it was Romaine all along.
The state of Michigan was even more careless in their response to vaping lung disease. The Michigan Department of Health and Human Services did not ban vitamin E acetate from THC cartridges until the end of November. The Detroit Metro Times reported that they neglected to mention THC cartridges were involved at all until well into October. This intentionally obtuse approach falsely shifted the blame to nicotine products and the generic “e-cig”.
Governor Gretchen Whitmer campaigned for cannabis legalization and accepted donations from lobbyists from the powerful industrial hemp and cannabis industries. Was she repaying a favor when Michigan completely failed to provide clear guidance to its citizens regarding the outbreak of vaping lung illnesses. There is no question that it took an unacceptably long period of time for THC cartridges to be called into question by the Michigan Department of Health and Human Services.
Now that the vaping lung disease issue has been cleared up, it is time to examine the strict e-cig laws that punish marginalized groups. The core arguments for flavor and vape bans have been gutted by the CDC. Unfortunately, it is anti-vaping dogma and not science that drives opponents of electronic nicotine delivery systems.