After months of surging numbers of people sickened and dying from vaping-related lung illnesses, the outbreak appears to be ebbing. Public health officials say that the leading culprit is vitamin E acetate, an additive found in some cannabis-based products, but that other substances may be playing a role.
A lack of certainty from the outset plagued the outbreak. The causes remained murky for much of the year and have been difficult for experts to tease out. Without clear answers to what caused the lung injuries, myths and misconceptions about the potential dangers gained traction as the number of confirmed cases of vaping-related lung illnesses nationwide topped 2,500, with 54 deaths.
As the year comes to a close, here’s what’s known:
Isn’t vaping a nicotine thing?
Yes, people vape nicotine, but they also vape cannabis products. In fact, the overwhelming majority of vaping-related lung illnesses, including those reported on in medical journals, involve tetrahydrocannabinol, known as THC. That’s the ingredient in marijuana that makes you high. Cartridges containing vitamin E acetate, mostly sold on the black market, are thought to be the main culprit.
Confusion between the dangers of nicotine and THC vaping may exist because the lung illnesses coincided with a big uptick in vaping by high school students, which prompted President Donald Trump and Health and Human Services Secretary Alex Azar to announce plans in September to ban all flavored nicotine vapes. But that hasn’t happened and state bans have been piecemeal. Instead, Congress raised the age to buy both tobacco and nicotine vapes to 21.
I vape only brand-name nicotine products purchased from actual stores, so I’m fine
It depends on why you’re vaping, what makes you worry and who you ask. If you started vaping to quit smoking, are under the supervision of a doctor, have tried and failed at other cessation options, are older than 21 and bought from a reputable retailer, you are probably at low risk of developing the acute lung illness, based on the advice from government officials. Still, you should try to quit as soon as possible. Much remains unknown about the long-term effects of vaping, but there are a variety of concerns about carcinogens in the chemicals.
Juul, the nicotine vape brand favored by young people, is the subject of many lawsuits for its marketing practices. So far three states, including New York, also have sued the company. Some plaintiff lawyers allege breathing problems and other illnesses, but the most obvious health issue is nicotine addiction, which can be very difficult to overcome and can lead to cigarette smoking and other risky tobacco use.
I buy my THC cartridges at a legal dispensary in my state, so I’m not at risk
At least eight states have reported lung illnesses linked to legal THC cartridges. Six probable vaping-related injuries in Massachusetts are linked to legal-market THC cartridges, and all 20 people so far sickened or killed with vaping-related disease in Oregon used THC bought from legal sources, state officials reported. The other states with lung illnesses linked to dispensary-purchased THC vape products are Michigan, Delaware, Maryland, Colorado, Utah and Washington.
The Centers for Disease Control and Prevention reported 152 different products were used by the 482 hospitalized patients who used THC vapes and provided information about the products they consumed. The four most common brands included two that are sold legally but had been widely counterfeited.
More: Is marijuana linked to psychosis, schizophrenia? It’s contentious, but doctors, feds say yes
Now that the government found vitamin E acetate is the culprit, THC vapers can relax
Government officials say vitamin E acetate, which is sometimes used as a thickening agent or to dilute THC oil in vape cartridges to make it go further, is the only additive they’ve confirmed linked to the lung illnesses and death. But CDC is continuing to look at other possible ingredients in THC or nicotine vapes that could be causing the illnesses. As CDC spokeswoman Nicole Elliott said earlier this month, “there remain a small but consistent number of (vaping lung illness) patients who report exclusive use of nicotine-containing products – something that does not commonly contain vitamin E acetate. These chemicals of concern could be present in e-cigarette, or vaping products, including THC, CBD, and nicotine-containing products.”
The devices themselves could even be contributing to the vaping-related lung illnesses, by emitting toxic chemicals, particularly if they are held together with lead or cadmium solder, experts told USA TODAY.
I might as well just smoke
So. Not. True. About two-thirds of people who smoke will die because of it, and about 400,000 people a year do. Smoking-related illnesses include cancer, emphysema, chronic obstructive lung disease and other debilitating chronic diseases. Vince Willmore, spokesman for the Campaign for Tobacco-Free Kids, says, “The absolute risks of the products (e-cigarettes) cannot be unambiguously determined at this time.” But if you switch completely from smoking to vaping – and don’t do both – there’s “conclusive evidence” that you will reduce your “exposure to numerous toxicants and carcinogens present in combustible tobacco cigarettes,” according to the National Academies of Science, Engineering and Medicine in January 2018.
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