Vaping

CDC Says Vaping-Related Lung Injuries Overwhelmingly Involve Black-Market THC Products, but It's Still Warning People to Avoid E-Cigarettes

In cases where the information was known, just 11 percent of patients said they had vaped only nicotine.

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According to numbers updated today, 1,888 cases of vaping-related lung injuries, including 37 deaths, have been reported to the Centers for Disease Control and Prevention (CDC) as of October 29. The CDC is now referring to these acute respiratory illnesses as cases of "e-cigarette, or vaping, product use associated lung injury (EVALI)," which is not only cumbersome but also misleading. While the term
e-cigarette typically refers to legal vaping devices, such as Juul, that deliver nicotine, the vast majority of the lung injuries have been linked to black-market cannabis products.

In cases where the information was available, according to a new CDC study, just 11 percent of patients said they had vaped only nicotine. The study notes that "data on substances used…were self-reported or reported by proxies and might be subject to recall bias, as well as social desirability bias because nonmedical marijuana is illegal in many states." In other words, since patients or their relatives may be reluctant to report illegal drug use, the role of black-market THC vapes could be even greater than the numbers suggest. The CDC also notes that patients may not actually know what was in the products they consumed, especially if they bought them online or off the street from illegal distributors.

"Use of THC-containing products was reported for 86% of patients who survived and 84% of patients who died," the study says. "Reports from Illinois, Utah, and Wisconsin suggest that patients have typically obtained their THC-containing e-cigarette, or vaping, products through informal sources, such as friends or illicit in-person and online dealers."

The CDC does not discuss the sources of nicotine products used by patients. But assuming that such products are in fact implicated in some cases, it seems likely that they also came from "informal sources" offering e-liquids of unknown provenance and composition. As psychiatrist Sally Satel, a resident fellow at the American Enterprise Institute, noted in her congressional testimony this month, "Consumers have been using commercially available vaping devices and nicotine products for 10 years without a single recorded death or any surge of illnesses…until this summer." The timing, she said, "is consistent with a relatively acute contamination" by additives or byproducts in illicit vapes. "The lung injury problem is a story of the dangers of the black market, not of vaping," Satel observed.

The CDC has gradually adjusted its advice to reflect the conspicuous role of black-market cannabis products in the lung disease outbreak. "Because most patients reported using THC-containing products before symptom onset, CDC recommends that persons should not use e-cigarette, or vaping, products that contain THC," it now says. "Persons should not buy any type of e-cigarette, or vaping, products, particularly those containing THC, off the street and should not modify or add any substances to e-cigarette, or vaping, products that are not intended by the manufacturer."

But the CDC still adds that "because the specific compound or ingredient causing lung injury is not yet known, and while the investigation continues, persons should consider refraining from the use of all e-cigarette, or vaping, products." That is not a sound recommendation for people who have switched to vaping from smoking, a far more hazardous source of nicotine.

The CDC implicitly acknowledges as much. "If you are an adult using e-cigarettes, or vaping, products, to quit smoking," it says, "do not return to smoking cigarettes." Yet the CDC's muddled messaging, including the unfounded insinuation that legal e-cigarettes might be deadly, continues to obscure the crucial point that they are much less dangerous than the conventional combustible kind.

NEXT: Cops Destroyed This House To Arrest a Shoplifter. A Federal Court Says Police Don't Have To Pay for the Damage.

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  1. 89% of patients had vaped illegal THC products, 11% of patients were smart enough to never trust the government with that information.

  2. But the CDC still adds that “because the specific compound or ingredient causing lung injury is not yet known, and while the investigation continues, persons should consider refraining from the use of all e-cigarette, or vaping, products.”

    “Also, cut back on sugar and get more exercise.”

  3. This argument is unfounded until information not mentioned is supplied. Of all people using vaping products, what percentage use THC products only, what percentage use nicotine products only, and what percentage use both? What is the distribution of illness in each of those groups?

    If a large majority of users of nicotine products are also users of THC products, the prevalence of THC use in the findings does little to implicate only THC.

    1. Given the relative market sizes of nicotine vapes vs even the largest estimates of black market THC vapes its safe to assume the majority of nicotine consumers do not in fact also consume THC products

  4. Because the CDC cleverly refers to all such devices as e-cigarette or vaping.

    The second reason is that the majority use both nicotine and THC.

    Now do a population study. That has not been done so far as I know. Assign relative risk to the following cohorts.

    Disposable commercial nicotine only

    Other nicotine vapes

    Tested THC vape only

    Other THC vapes

    Then run combinations of the above.

    There is no way to make any sense without looking at the population as a whole divided into groups instead of just looking at those with the disease. What you have now is just a case series basically which is the weakest form of evidence.

    The CDC knows this which is why they are just taking the blanket “don’t do it” approach. They cannot rule anything out at this point.

    1. Just to add you could use non vapes as a control group. Ok where is my grant?

    2. Here is some more info for you.

      https://www.cdc.gov/media/releases/2019/p1028-first-analysis-lung-injury-deaths.html


      Among 867 patients with available data on specific e-cigarette, or vaping, product use in the three months preceding symptom onset, 86% reported any use of THC-containing products, 64% reported any use of nicotine-containing products, 52% reported any use of both THC-containing products and nicotine-containing products, 34% reported exclusive use of THC-containing products, and 11% reported exclusive use of nicotine-containing products.

      1. Thanks I had seen that report. Good to put it out there.

        I am not faulting CDC at all they are reporting data as they get it. They are a valuable resource.

  5. The MOST the government ought to do in this case, with respect to vaping, is to require a warning label that fairly assesses the risks of vaping. That is the MOST.

    But by no means should they ban it.

  6. Act like men. Smoke Marlboro.

  7. electronic-cigarette (e-cigarette), or vaping, product use–associated lung injury (EVALI)

    One supposes even the CDC deemed it too much to say “electronic-cigarette or vaping injury of the lung (EVIL)”.

  8. This article goes much too easy on the CDC. They are lying. They know full well that e-cigarettes are harmless. Someone should probe and see if there is even ONE example where it is clear someone was injured by a nicotine e-cigarette— as opposed to self-reports that claim they were not using illegal substances. I’ve yet to see any news source come up with that one definite example.

  9. Given the hospitalizations/examinations of these patients, what possible excuse could there be for not having tested their blood samples for THC? Of COURSE 10% or so of the general population of young people are going to deny “vapin’ pot” while their parents are standing by their bedsides! It’s bad enough they’re having to admit to vaping at all with all the antivape sentiment from Antismokers dressed up in new costumes.

    There is no excuse I can see at ALL other than doctors who believe it’s “better” to send out a general antivaping message to “the youth of America” … regardless of the consequences.

    Conflating these problems with vaping in general to pass laws is like trying to make Grandpa’s Meerschaum pipes illegal because of what pipes do to meth addicts!

    – MJM, who’ll now start a campaign against forks because they make people fat!

  10. Given the hospitalizations/examinations of these patients, what possible excuse could there be for not having tested their blood/hair samples for THC? Or asked to check the vape-cig devices? Of COURSE 10% or so of the general population of young people are going to deny “vapin’ pot” while their parents are standing by their bedsides! It’s bad enough having to admit vaping at all in today’s antismoking climate built by Antismokers dressed up in new costumes.

    There is no excuse I can see at all for such important neglect other than doctors believing it’s “better” to send out a general antivaping message to “the youth of America” … regardless of the consequences.

    Conflating these problems with vaping in general to pass laws is like trying to make Grandpa’s Meerschaum pipes illegal because of what pipes do to meth addicts!

    – MJM, who’ll now start a campaign against forks because they make people fat!

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