Vaping-Related Lung Illnesses

 
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CDC CITES DANK VAPES AS MOST COMMONLY REPORTED BRAND IN THC-VAPING LUNG ILLNESSES

December 20, 2019
  • It wasn’t until December 3 that CDC finally named specific brands of THC-devices in its report. On August 20, The Heartland Institute warned policymakers of the possible problems associated with Dank Vapes.

    • Heartland reported there was a “thriving” black market for THC vaping products.

    • We found (now-defunct) listings on Amazon and eBay, where one could easily purchase empty packages under the Dank Vape label, which has overwhelmingly been noted on the black market as being a “legitimate” THC product.

    • We also found empty cartridges available for sale online, and YouTube tutorials on how to extract wax from marijuana to use in a vaping device, including one tutorial employing the use of a hair straightener.

    • A September report only examined patients in Illinois and Wisconsin, finding 84 percent of patients had reported using THC-vaping devices. Further, 21 of 41 patients interviewed admitted using a THC-vaping device “marketed under the ‘Dank Vape’ label.”

    • In October, the Heartland Institute reported that a September report from the Utah Department of Health found 94 percent of patients with a vaping-related lung illness reported using THC vaping products. Moreover, 38 percent of patients reported using a Dank Vapes THC device.

  • Since August, The Heartland Institute has been investigating both CDC and state health department profiles of lung injuries supposedly linked to electronic cigarettes and vaping devices.

    • A September 10 Research & Commentary found that of the six states (California, Illinois, Indiana, Kansas, Minnesota, and Oregon) reporting vaping-related deaths, two states (Oregon and Minnesota) explicitly linked the deaths to THC-containing vaping products.

    • A September 24 Research & Commentary reported three more states—Connecticut, New York, and Utah—also linked vaping-related lung illnesses to the use of products containing THC.

  • It’s disturbing that CDC waited until December to report this particular brand, especially as the 2019 Monitoring the Future survey found that marijuana vaping among youth “ranked among the largest single-year increases ever observed by Monitoring the Future in the past 45 years among all outcomes ever measured.

  • 21 percent of 12th graders, 19 percent of 10th graders, and 7 percent of 8th graders reported ever use of vaping THC products in the past 12 months.

CENTERS FOR DISEASE CONTROL AND PREVENTION FIND OVER 80 PERCENT OF VAPING-RELATED ILLNESSES ATTRIBUTABLE TO THC

November 26, 2019
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  • As of November 20, 2019, the CDC has identified 2,290 cases of vaping-related lung injuries in 49 states and Washington, D.C. This includes 45 deaths confirmed in 25 states.

    • Of the deceased, the median age “was 53 years and ranged from 17 to 75 years.”

  • CDC was able to obtain information on 1,184, or 51.7 percent, of patients with vaping-related lung illnesses. Of these, “83% reporting using [tetrahydrocannabinol] THC-containing products,” with “35% reporting exclusive use of THC-containing products.

  • This report comes after CDC examined 29 patients with vaping-related lung injuries, finding that vitamin E acetate was present in all 29 samples.

  • It is important to note neither CDC or state health departments have been able to identify a single chemical, let alone product, that could be causing adverse health effects.

  • Many other state health departments have determined a majority of their patients are reporting use of THC-containing e-cigarettes, which are often illegal, black market products, containing unknown substances.

  • Although vitamin E acetate’s role in the current outbreak is unknown, it “has been identified as a ‘very strong culprit’ in lung injuries related to vaping THC.”

    • The New York State Department of Health announced results from laboratory testing on vaping products. The “results showed very high levels of vitamin E acetate in nearly all cannabis-containing samples analyzed.”

    • The Utah Public Health Laboratory tested 39 vaping devices: 51 percent contained e-liquid nicotine and 49 percent contained THC. 90 percent “of the THC cartridges contained Vitamin E acetate.”

  • Moreover, many patients are reporting vaping illegal, black market products. A report in of 53 patients in Illinois and Wisconsin noted that 84 percent reported vaping THC products, with 21 of the 41 patients reporting using a “Dank Vape” product.

  • Despite recent fearmongering, electronic cigarettes and vaping devices are overwhelmingly less harmful than combustible cigarettes.

  • Electronic cigarettes and vaping devices are tobacco harm reduction tools.

  • E-cigarettes are twice as effective as traditional nicotine replacement therapy in helping smokers quit combustible cigarettes.

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LATEST CDC REPORTS

LINK VITAMIN E TO VAPING LUNG ILLNESSES

November 12, 2019
  • A November 8 Morbidity and Mortality Weekly Report (MMWR) by the Centers for Disease Control and Prevention (CDC) that noted vitamin E acetate may be the chemical agent that is causing recent vaping-related lung injuries.

  • CDC used data from 10 state health departments (California, Connecticut, Hawaii, Illinois, Maryland, Michigan, Minnesota, Texas, Utah, and Wisconsin) that included detailed health records on 29 patients.

    • Vitamin E acetate was found in all 29 patient samples.

    • 23 patients “self-reported” using vaping devices containing tetrahydrocannabinol (THC).

    • THC was also detected in “three patients who said they did not use THC products.

  • The report is rather late, as state health departments linked vitamin E acetate in September, 2019

    • On September 5, the New York State Department of Health (NYDOH) reported lab results “showed very high levels of vitamin E acetate in nearly all cannabis-containing samples analyzed.”

    • The Utah Department of Public Health announced on September 16 the state’s Public Health Laboratory tested 39 vaping products, including 19 THC-containing cartridges and 20 nicotine-containing products.

      • Vitamin E acetate was detected in 90 percent of the THC-cartridges, whereas 100 percent of nicotine-containing liquids “contained nicotine and none have shown unexpected compounds.”

  • Connecticut, Minnesota, Oregon, and Texas have all found that patients with vaping-related lung injuries self-reported use of THC vaping products.

  • An October 15 CDC report found 78 percent of patients with lung illnesses associated with e-cigarettes reported vaping THC-containing devices, and only 10 percent self-reportedexclusive use of nicotine-containing products.”

  • Many of these THC cartridges are illegal black-market products with unknown chemical ingredients.

    • A September NBC News study tested “15 black market cannabis vape carts,” finding 13 of the cartridges “came back positive for containing Vitamin E acetate.

    • A September 6 report in The New England Journal of Medicine examined vaping-related hospitalizations in Illinois and Wisconsin; in these cases, 21 of 41 patients reported “using a THC product … marketed under the ‘Dank Vape’ label.” 

  • Despite recent fear mongering, e-cigarettes and vaping devices are tobacco harm reduction tools that have helped an estimated three million American adults quit smoking since 2007.

TENNESSEE DEPARTMENT OF HEALTH LACKS TRANSPARENCY ON VAPING-RELATED LUNG ILLNESSES

November 5, 2019
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  • The Tennessee Department of Health (TDOH) is omitting information on substances vaped in recent lung injuries, despite Centers for Disease Control and Prevention (CDC) and other state health departments linking recent vaping-related lung illnesses to the use of products containing tetrahydrocannabinol (THC).

    • On October 17, TDH reported “a patient with serious respiratory disease associated with use of electronic cigarettes or other vaping devices” passed away.

    • On August 22, TDH issued an alert, “asking health care providers … to report any cases of suspected respiratory illness[es]” believed to be caused by vaping. On September 9, TDH identified six possible cases of vaping-related lung illnesses.

  • As of October 17, TDH has identified “53 lung injury cases associated with e-cigarette use or vaping.”

    • Of the 53 patients, 66 percent are male, and the “median age of patients is 24 years old and ages range from 16 to 56 years.”

  • TDH does not provide any information on what type of vaping devices were used by these patients prior to their illnesses. However, TDH does note, “national data suggests the products containing THC … are linked to most of the cases and play a major role in the outbreak.

  • TDH’s lack of transparency surrounding vaping-related lung illnesses is alarming. Further, the death reported in Tennessee was a Minnesota native who admitted to vaping devices containing THC and cannabidiol (CBD) oils.

  • In an October 15 update, CDC found 78 percent of self-reporting patients with vaping-related lung illnesses reported using vaping products containing THC.

  • The Minnesota Department of Health (MDH) reported the state’s first vaping-related death on September 6, 2019, noting the patient’s “lung injury was associated with vaping illicit THC products.

    • On October 16, 2019, MDH reported two more deaths from vaping-related lung illnesses. According to MDH, one patient admitted to vaping “illegal THC” and the second also admitted “vaping unknown products in addition to nicotine.

  • Other state health departments have also provided details on products used by patients with lung illnesses supposedly due to vaping.

    • The Utah Department of Health noted 94 percent of patients with vaping-related lung illnesses reported use of “any THC cartridges.

    • In a now defunct webpage, the California Department of Health found 81 percent of their state’s patients “vaped [a] product containing THC.

    • On October 11, the Iowa Department of Public Health reported that of 38 cases of possible vaping-related lung injury, 33 patients, or 86 percent, reported vaping THC-containing devices.

  • Tennessee law enforcement is well aware of the problem of black-market THC vaping products.

    • In November 2017, the Robertson County sheriff’s department seized “seven pounds of high grade marijuana and 31 vials of high potency THC vape liquid … a street value of about $30,000.”

    • In April, 2019, Nashville law enforcement collected “over 26 THC vape pens that contained 85 to 90-percent THC oil.” The 19 year-old in possession of the THC vaping devices “admitted he would buy the pens for $18 and sell them for $40.”

  • Despite recent headlines, e-cigarettes are substantially safer than traditional, combustible cigarettes. The American Cancer Society declared that “e-cigarette use is likely to be significantly less harmful for adults than smoking regular cigarettes.” This is attributed to the fact that “e-cigarettes do not contain or burn tobacco.

CENTERS FOR DISEASE CONTROL AND PREVENTION REPORTS THC-CONTAINING DEVICES CAUSE MOST VAPING ILLNESSES

October 21, 2019
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  • Lindsey Stroud the latest report by the Centers for Disease Control and Prevention which found 78 percent of patients with vaping-related lung illnesses reported vaping products containing tetrahydrocannabinol (THC).

  • On October 15, CDC reported “1,479 lung injury cases associated with e-cigarettes or vaping.” CDC was provided data on 1,358 patients and found:

    • 70 percent are male.

    • The median age of the 1,358 patients “is 23 years and ages range from 13 to 75 years.”

  • CDC obtained information on types of substances vaped for 849 patients. Of these, 78 percent reported using vaping products containing THC only 10 percent self-reported “exclusive use of nicotine-containing products.”

  • On October 10, CDC found that of patients with lung-illness attributed to vaping devices, 76 percent “reported using THC-containing products,” and 13 percent “reported exclusive use of nicotine-containing products.”

  • Similar to CDC’s findings, many states have linked recent vaping-related hospitalizations to THC-containing products.

  • Overwhelmingly, a notorious black-market THC product (that is completely illegal) is being linked to recent vaping-related hospitalizations.

  • Despite these findings, many states are moving to restrict access to tobacco harm reduction products that are regulated and have yet to be definitively linked to any adverse health effects.

  • In June 2019, the American Cancer Society declared e-cigarettes to be significantly less harmful for adults than smoking regular cigarettes […] because e-cigarettes do not contain or burn tobacco.

CONNECTICUT DEPARTMENT OF HEALTH LACKS TRANSPARENCY WHEN REPORTING VAPING-RELATED HOSPITALIZATIONS

October 16, 2019
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  • Lindsey Stroud examines reports by the Connecticut Department of Public Health (CDPH), finding the department is now omitting specific details about recent vaping-related hospitalizations.  

  • On August 21, 2019, CDPH reported two cases of vaping-related hospitalizations involving patients who admitted to vaping “both nicotine and marijuana products.”

  • On September 19, CDPH confirmed 11 more cases, for a grand total of 13. Of these, CDPH interviewed nine patients, who all admitted “using vaping products containing tetrahydrocannabinol (THC), a psychoactive component of the marijuana plant.”

  • CDPH press releases on October 3 and October 11 did not mention anything about which substances individuals vaped prior to hospitalizations.

  • Recently, the Centers for Disease Control and Prevention (CDC) found a majority of vaping-related hospitalizations were due to vaping THC products. On October 3, CDC announced 78 percent of patients with vaping-related illnesses “reported using THC-containing products.” Similar results have been reported by health departments in Minnesota, Oregon, Texas, and Utah.

  • It is imperative lawmakers understand these illegal, unregulated THC-laden “vaping cartridges,” which are mostly homemade or available on the black market, are not e-cigarette products regulated by the U.S. Food and Drug Administration (FDA).

    • E-cigarettes and vaping devices first entered the U.S. market in 2007.

    • In 2012, FDA was granted authority to regulate vaping devices as tobacco products.

    • In 2016, FDA extended its regulatory authority over e-cigarettes, issuing deeming regulations. Under these rules, no new vaping product could come to market after August 8, 2016, without first completing a premarket tobacco application.

  • An estimated three million American adults have used vaping devices to quit smoking tobacco cigarettes. Further, e-cigarettes are twice as effective as nicotine replacement therapy in helping smokers quit.

  • In June June 2019, the American Cancer Society found “e-cigarette use [is] significantly less harmful for adults than smoking regular cigarettes […] because e-cigarettes do not contain or burn tobacco.”  

  • Making matters worse, far too many policymakers seek to reduce youth e-cigarette use, yet spend little tobacco revenue on such programs. 1998, Connecticut joined other sates in settling with tobacco companies in what became known as the Master Settlement Agreement (MSA).

UPDATED CDC REPORT ON VAPING-RELATED HOSPITALIZATIONS FINDS NEARLY 80 PERCENT LINKED TO THC PRODUCTS

October 9, 2019
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  • Lindsey Stroud examines a recent report by the Centers for Disease Control and Prevention (CDC) finding that 78 percent of recent vaping-related hospitalizations have been linked to the use of vaping devices containing tetrahydrocannabinol (THC).

  • 37 percent of patients reported “exclusive use of THC-containing products.

  • These findings are similar to a CDC Morbidity and Mortality Weekly Report (MMWR) published as Early Release on September 24, 2019.

    • Of the 514 patients self-reporting, 395, 77 percent, “reported using THC-containing products.”

  • CDC’s findings are similar to reports from several state health departments

  • Even states in which no vaping-related deaths have occurred have had patients report use of vaping devices containing THC.

    • The Connecticut Department of Public Health “interviewed 9 of the 13 patients with vaping-related injury.” All nine patients reported using THC products.

    • According to the Texas Department of State Health Services, 87 percent of interviewed patients “reported vaping products containing [THC].”

    • The Utah Department of Health (UDOH) reported “71 cases of vaping-related lung injury.” UDOH gathered data on 36 cases and found 34 patients, or 94 percent, self-reported use of “any THC cartridges.” In Utah, 13 patients, or 36 percent, reported exclusive use of THC vaping devices.

  • Utah Public Health Laboratory tested 39 vaping devices: 51 percent contained e-liquid nicotine and 49 percent contained THC. Among the nicotine-containing liquids, 100 percentcontained nicotine and none have shown unexpected compounds.” On the other hand, 90 percent of the THC cartridges contained Vitamin E acetate.

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CENTERS FOR DISEASE CONTROL AND PREVENTION LINK MAJORITY OF VAPING-RELATED HOSPITALIZATIONS TO THC PRODUCTS

September 30, 2019
  • Lindsey Stroud examines the Centers for Disease Control and Prevention’s (CDC) latest Morbidity and Mortality Weekly which linked more than 70 percent of recent vaping-related hospitalizations to the use of vaping devices containing tetrahydrocannabinol (THC).

  • As of September 24, CDC has identified 805 reported cases of vaping-related hospitalizations in 46 states and one U.S. territory.

    • 69 percent of patients were males.

    • The median age was 23 years, with a range from 13 to 72 years.

    • There have been 12 deaths reported in 10 states, including California (two deaths), Florida, Georgia, Illinois, Indiana, Kansas, Minnesota, Missouri, Mississippi, and Oregon (two deaths).

  • Of the 805 cases, information on substances used was available for 514 patients, or 64 percent of reported cases.

    • 395, or 77 percent, reported vaping THC-containing products.

    • 210 patients, or 41 percent reported using both THC and nicotine products.

    • Only 82, or 16 percent self-reported exclusive use of nicotine products.

  • At this time, the CDC still does not know the “specific chemical exposure(s) causing this outbreak.”

  • These findings are similar to other state findings.

    • On September 16, the Utah Department of Health linked the state’s hospitalizations to THC products, with 60 percent of individuals “self-reported vaping nicotine” and 90 percent “self-reported vaping THC.”

    • On September 19, the Connecticut Department of Public Health had “interviewed 9 of the 13 patients with vaping-related injury.” All nine patients reported using THC products.

    • On September, 26, the Oregon Health Authority (OHA) reported the state’s second vaping-related death, finding the patient “had been hospitalized with respiratory symptoms after vaping cannabis products.” Earlier, on September 3, OHA announced the first vaping-related death, which was a patient who “had recently used an e-cigarette or vaping device containing cannabis purchased from a cannabis dispensary.

    • On September 23, the Texas Department of State Health Services reported a total of 89 cases under investigation, with 34 “classified as confirmed cases,” and 20 “classified as probable cases.” Of these, 76 percent “reporting vaping products containing [THC].

  • Lawmakers should refrain from enacting legislation that would further restrict adult access to electronic cigarettes and vaping devices.

  • Numerous public health groups, including Public Health England, the Royal College of Physicians, and the American Cancer Society have found e-cigarettes to be significantly less harmful than combustible cigarettes.

MORE STATE HEALTH DEPARTMENTS LINK RECENT VAPING-HOSPITALIZATIONS TO THC

September 24, 2019
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  • Lindsey Stroud examines additional health department findings which linked recent vaping-related hospitalizations to the use of vaping devices containing tetrahydrocannabinol (THC).

  • As of September 16, the Utah Department of Health noted 60 percent of individuals “self-reported vaping nicotine” and 90 percent “self-reported vaping THC.”

  • As of September 19, the Connecticut Department of Public Health had “interviewed 9 of the 13 patients with vaping-related injury.” All nine patients reported using THC products.

  • These recent findings mimic earlier findings. The Oregon Health Authority reported an individual who died in July 2019 “had recently used an e-cigarette or vaping device containing cannabis. The Minnesota Department of Health reported an individual died from a “lung injury [that] was associated with vaping illicit THC products.

  • In late August 2019, the Wisconsin Department of Health Services noted 89 percent of patients “reported using e-cigarettes or other vaping devices to inhale THC products, such as waxes and oils.”

  • The vast majority of vaping devices sold in convenience stores and vape shops are regulated.

  • In 2016, FDA issued deeming regulations that extended the agency’s authority over e-cigarettes and vaping devices.

    • Since 2016, all e-cigarette products must complete a lengthy and expensive process known as a “premarket tobacco product application.”

    • Additionally, FDA required all e-cigarette products be registered with the agency by December 31, 2016.

  • As more states link vaping-related hospitalizations to the use of unregulated THC-cartridges, it is disingenuous and counterproductive for lawmakers to place restrictions and/or bans on products that have helped an estimated three million Americans quit smoking.

  • E-cigarettes are 95 percent less harmful than tobacco cigarettes and twice as effective as traditional nicotine replacement therapy.

VAPING-RELATED HOSPITALIZATIONS AND DEATHS LINKED TO THC PRODUCTS

September 10, 2019
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  • Officials in six states (California, Illinois, Indiana, Kansas, Minnesota, and Oregon) have confirmed recent deaths to lung disease in individuals that had reported recent e-cigarette use.

  • Two deaths have been linked to use of cannabis and THC products:

  • In August, the Wisconsin Department of Health Services reported 89 percent of patients interviewed had “reported using e-cigarettes or other vaping devices to inhale THC products, such as waxes and oils.”

  • A September 6 report in The New England Journal of Medicine examined hospitalizations in Illinois and Wisconsin. Of the 53 case patients the authors examined, 84 percent “reported having used [THC] products in e-cigarette devices.

  • Lawmakers should refrain from enacting legislation and policies that could further restrict adult access to proven tobacco harm reduction products.

  • The American Cancer Society (ACS) stated “e-cigarette use is likely to be significantly less harmful for adults than smoking regular cigarettes.” ACS notes that “[t]his is mostly because e-cigarettes do not contain or burn tobacco.

  • A 2019 study found e-cigarettes to be twice as effective as traditional nicotine replacement therapy, in helping smokers quit. Moreover, their use can help reduce smoking-related health care costs.

Image by DeMorris Byrd

VAPING HOSPITALIZATIONS LIKELY LINKED TO BLACK MARKETS

August 20, 2019
  • Recent headlines report there is an increase in hospitalizations due to vaping but health departments cannot identify a specific legal, regulated product that could have caused adverse health effects.

  • There is a thriving illegal black market for empty cartridges and boxes that can be easily filled with illegal, unregulated substances.

  • Synthetic marijuana and THC vape pens have sent teenagers to the hospital in states where recreational marijuana is illegal.

  • Lawmakers should refrain from restricting access to legal e-cigarette products that are regulated by FDA.

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