No Single Brand Responsible for Vaping Crisis, Says CDC

It’s “unlikely” that a single brand of vaping products is responsible for the US’s recent vaping crisis, according to the Centers for Disease Control and Prevention (CDC).

Instead, the outbreak of e-cigarette or vaping associated lung injuries (EVALI) appears to be strongly tied to the illicit market; the CDC found that one counterfeit THC brand, Dank Vapes, was used by 56 percent of hospitalized EVALI patients nationwide.

But legitimate THC vaping products haven’t got the all-clear just yet. In Massachusetts, at least six suspected EVALI patients purchased THC products at licensed dispensaries, according to the state’s department of public health.

Vaping bad

As of December 4, the EVALI outbreak has been associated with the deaths of 48 people and the lung injuries of 2,291 others.

Fortunately, the crisis seems to be abating. The proportion of hospitalized EVALI patients reported to the CDC declined from 58 percent on November 12 to 30 percent on December 3.

But while the outbreak appears to be losing its grip, health professionals have yet to grasp its cause.

Around 80 percent of the hospitalized EVALI patients said they vaped THC, yet the intoxicating cannabinoid has never been known to cause lung injuries. “It's not the THC that's making people sick, and I think that's a really important distinction to make,” Dr Swetha Kaul, the chief scientific officer at Cannalysis, a state-licensed cannabis testing facility in California, told Analytical Cannabis in October.

Around 12 percent of patients also said they vaped CBD, while 13 percent claimed they vaped only nicotine.

So with no clear culprit among the key chemicals, many analysts have since suspected the kind of additives and thickening agents commonly found in illicit products, such as the cosmetic compound vitamin E acetate.

The CDC’s new findings seem to support this thinking; Dank Vapes, a class of largely counterfeit THC-containing products, were the most commonly used brand among EVALI patients nationally and by US census region.

According to an Inverse investigation, Dank Vapes is largely a brand name printed on boxes in China, which are then shipped to thousands of black market vape dealers across the US. As Mark Hoashi, the CEO of the cannabis review app Doja, told the publication, “these are just people filling cartridges as ‘Dank Vapes.’ It’s just people in their garages filling them and selling them.”

A word of cannabis caution

But while the CDC’s recent report damns Dank Vapes, legal THC vaping products have also been implicated in EVALI cases.

On Friday, the Massachusetts Department of Public Health reported that at least six patients suspected of EVALI purchased THC products at licensed marijuana dispensaries in the state.

However, these six EVALI cases were only deemed as “probable” legal purchases by the health authorities and haven’t been confirmed. Indeed, the only reports the authorities have confirmed are ten EVALI cases linked to THC products that weren’t bought at a Massachusetts dispensary.

So although more evidence will be needed to properly identify the vaping crisis’ culprit, the confirmed evidence again links the outbreak to the illicit market rather than its regulated, legitimate counterpart.

In October this year, two separate studies from commercial testing labs found that vitamin E acetate, the thickening agent suspected to be the cause of EVALI, was entirely absent from the legal cannabis vaping market in California. One of the studies even found vitamin E acetate in 9 of the 12 illicit products tested.

“Vitamin E acetate is very heavily used in the illegal vaping market; 20, 30, 60 percent of a cartridge could be vitamin E acetate,” Dr Kaul told Analytical Cannabis.

“The safer option is to shop [for] legal, tested products. I feel like that's the messaging that might resonate,” she said. “Because if you just tell people to stop vaping, they're just going to ignore the entire message. So how about giving them a route where at least their chances of staying safe are higher and better?”