“We Need To Make It Safer:” Dr Graham Wood on the Vaping Crisis
The US’s “vaping crisis” isn’t showing any signs of slowing down. As of October 29, 37 deaths and 1,888 lung injuries have been attributed to e-cigarettes, according to the Centers for Disease Control and Prevention (CDC) – an increase on the 33 deaths and 1,479 injury cases announced just two weeks prior.
The majority of these illnesses have been associated with THC vaping products, likely sourced from the illicit market. And while the true chemical cause of the crisis remains unknown, investigators from the US Food and Drug Administration have connected an oil found in illicit THC vaping products owned by patients to their illness: vitamin E acetate.
Recent studies by third-party cannabis testing labs in California have since shown that the suspected vitamin E substance isn’t present in legal vaping products but is sold in illicit counterfeits.
“It's the illicit market plus the actual counterfeits,” says Dr Graham Wood, the chief scientific officer at Neptune Wellness Solutions, an extraction services company. “The labelling looks exactly the same, but it's not their vape oil that it's in there, it's someone else's.”
“If someone isn't following the best practices and just putting stuff out there with either cheap processes, I think that is likely the major cause of what is being seen right now with the vape-related injuries,” he adds.
But as the case builds up against vitamin E acetate and the illicit market, experts like Wood – who will be presenting an Analytical Cannabis webinar on the safety of vaping later this month – are cautiously advising that investigations shouldn’t stop there.
A heavy burden
“Even if the culprit for these vape related injuries turns out to be, say, vitamin E, it doesn't mean we should take stop focusing on the other potentials,” says Wood.
With the health and safety spotlight now firmly on vaping, Wood says that regulators shouldn’t miss this chance to properly assess vaping’s potential harms. “We need to keep our eyes on all the potential issues,” he says.
“[If] you pick up vape juice before it goes into in contact with the heating coil, everything is perfectly fine,” he adds. “[But] if you have it sit there next to the heating coil, heavy metals start to show up, and then when you aerosolize it, high levels of heavy metals come out. So I think there's an issue there.”
“We have to look at the construction of the devices, the coils, what's used, whether it's a bare metal coil versus a ceramic heating element,” Wood adds. “I think all those things need to be taken into account.”
While most US state regulators recommend labs screen cannabis vaping oils for lead, cadmium, arsenic, and mercury, these tests come too early to detect any heavy metals produced by an e-cigarette’s vaporization process. As Rob Thomas, a principal consultant of Scientific Solutions, explained to Analytical Cannabis last month, “many of the cannabinoid delivery devices, particularly vaping sticks, are picking up heavy metals, not from the cannabis product, not from the liquid or the oil, but from the metallic components inside these vaping devices.”
“And we don’t have a clear understanding of the problem at the moment, because the industry is not really investigating it,” Thomas added.
With the CDC and other federal agencies now studying the effects of vaping more than ever before, perhaps the industry will soon have a better understanding of vaping’s role in heavy metal exposure, along with new regulations to prevent such poisonings.
A change of regulations
But with regulators’ investigations into vaping products come regulators’ warnings against using them. The FDA is still advising consumers to completely avoid vape products that contain THC, for example, whether bought from legal dispensaries or “obtained off the street.”
Some lab analysts have argued that these blunt warnings create a false equivalence and push consumers into the illicit market. But Wood has sympathy with the FDA’s message and others like it.
“I mean, they're in a tough situation. Their responsibility is to protect the public. And as of right now, they don't have an exact answer,” he says. “So, in a way, to fulfil their mandate, that's kind of what they needed to do: to raise the alarm.”
And by any measure, the alarm has certainly been raised. In September, President Donald Trump announced his administration’s intention to ban flavoured e-cigarettes, and several US states, including New York, Washington, Oregon, Massachusetts, Michigan, and Rhode Island, have moved to restrict sales of the flavored vaping products. The real concern, Woods says, will be if these initial warnings drown out any subsequent information.
“I hope as it gets narrowed down to the true culprit, they revise their recommendations based on the evidence that comes out,” he says. “I hope that there's the same media attention to it as well. Sometimes when those details come out, it doesn't get the same attention. So then the public don't hear it.”
Unfortunately, as current rates stand, it seems inevitable that more deaths and lung injuries will be reported before the true cause of the vaping illness is identified. But in the meantime, the crisis could be an opportunity; a chance to properly asses every danger e-cigarettes can pose to consumers, so future products can be as safe as possible. Considering the great benefits vaping already provides over other cannabis delivery systems, Wood says, the industry can’t afford to lose them.
“I think vaping is a great delivery system,” Wood says. “It's quite easy for consumers to control their dosing levels versus some of the edibles. Vaping gets rid of those issues.”
“But just because it's better for giving that fine control, it still has to be as safe. So I think we need to make sure that we're really paying attention to what's going in there. And as clinical studies continue, we're making it safer and safer as time goes on.”
Graham Wood will present the Safety of Vaping: Facts, Misconceptions and Fiction on the 19th of November. You can register online here.