Potential Causes Behind the Vaping-Related Illness [Latest Update]

More than 450 individuals, predominantly teenagers, have developed a severe respiratory illness linked to vaping. Six fatalities have been reported. Recently, the Washington Post highlighted that health authorities are focusing on a specific chemical found in cannabis samples: vitamin E acetate.

As reported by Rolling Stone, vitamin E acetate is a primary component in thickening agents used to dilute cannabis oil in illicit THC vape products:

Historically, vitamin E oil was utilized in smaller quantities, typically constituting less than 20% of the mixture, according to Peter Hackett, president of AirVapor Systems, a vape hardware supplier.

 

However, due to a cannabis supply shortage in California — driven by the implementation of 'track and trace' protocols and rising demand — illegal suppliers are now incorporating higher proportions of thickeners, sometimes exceeding 50%, to compensate for low-potency vape cartridges. Hackett notes, 'There’s so much cutting agent that even the manufacturers of these agents didn’t anticipate such extensive dilution.'

New York State has issued subpoenas to three companies that supply these chemicals, urging them to assist in ongoing investigations. Meanwhile, Wisconsin officials recently raided a facility producing counterfeit THC vapes.

The CDC has previously advised that individuals should 'consider refraining from using e-cigarette products' while investigations are ongoing. This recommendation applies to THC vapes as well.

What is vitamin E acetate?

Vitamin E is a well-known nutrient essential for survival, commonly present in vegetable oils, nuts, seeds, and certain leafy greens.

Vitamin E acetate, while safe for consumption, is widely used in skincare products due to its extended shelf life compared to other forms of vitamin E. It is deemed safe for both topical application and ingestion.

However, this does not imply it is safe to inhale. Unidentified officials informed the Washington Post that its 'oil-like characteristics might be connected to the respiratory symptoms reported by numerous patients, such as coughing, difficulty breathing, and chest pain.'

How confident are they in identifying the cause of the illness?

Not entirely. The CDC’s official page on the illness states that 'no specific substance or e-cigarette product has been linked to all cases.' A recent press release added: 'The FDA is examining samples from patients for a wide range of chemicals, but no single substance, including vitamin E acetate, has been found in all samples. Identifying compounds in the samples is just one part of the puzzle and does not necessarily establish causality, underscoring the importance of ongoing research.'

Many affected individuals had used cannabis products. While some of these products were tested for contaminants, not all were examined. Most of those tested showed traces of vitamin E acetate.

New York State’s health department stated that after analyzing patient-provided samples, vitamin E acetate was detected in 'nearly all' cannabis-containing samples, including at least one product from each patient, but none were found in nicotine-only samples.

Consequently, vitamin E acetate has become a 'primary focus' of New York’s investigation and appears to be a significant concern for the FDA as well.

How can I ensure my vaping products are safe?

Currently, there is no guaranteed method. Keep in mind that it remains unclear whether vitamin E acetate is the actual cause of these illnesses. It might be a distraction or one of multiple contributing factors. Additionally, vitamin E acetate may not always be disclosed on product labels.

The CDC advises the public to avoid vaping until the situation is fully understood. They also recommend refraining from purchasing vaping products from unauthorized sources, using cannabis-containing vapes, or modifying vape liquids. If you suspect a product is causing health issues, contact poison control or seek medical assistance, and consider reporting the product to the FDA.

Update 9/6/2019, 3:13pm: This post has been updated to include details from a CDC press release issued today.

Update 9/12/2019, 12:00pm: This post has been revised to include additional details regarding authorities investigating the presence of vitamin E acetate in illicit THC vape products.