Mysterious Vaping-Related Lung Illness Strikes U.S.: Is Your E-Liquid Safe?

By  //  December 12, 2019

Beginning in summer 2019, a mysterious lung illness began to strike vapers around the United States. The number of people sickened by the illness grew rapidly, with the total number of reported illnesses exceeding 2,200 by the year’s end.

Beginning in summer 2019, a mysterious lung illness began to strike vapers around the United States. The number of people sickened by the illness grew rapidly, with the total number of reported illnesses exceeding 2,200 by the year’s end.

The American media – never exactly known for having a fair and balanced perspective with regard to vaping – quickly latched on to the story, targeting e-cigarettes and nicotine e-liquid as possible culprits behind the illness.

What many media outlets completely failed to mention, however, is that there is a second and completely different form of vaping that has taken hold on the streets across America: illicit THC vaping.

Black market marijuana vaping oils are so popular that a Leafly estimate suggests there could be as many as 50 million illegal THC vaping cartridges circulating on American streets right now. 

The majority of the over 2,200 people confirmed to have contracted the E-Cigarette or Vaping Product Use-Associated Lung Injury – or EVALI as it’s come to be called – have admitted to using THC products.

Many of those who claimed that they only used nicotine e-liquid products were later found to be lying. 

Federal officials have collected and analyzed lung fluid from 29 EVALI victims. In all of the lung fluid samples, researchers found Vitamin E acetate, a substance not found in any commercial nicotine e-liquid.

So, what’s going on? Are you safe to continue buying e-liquid from a major vendor like Reading this article, you’re going to learn more about the nature of EVALI and gain a better understanding of how it relates to traditional e-cigarettes and nicotine e-liquid vaping. 

What Is EVALI?

EVALI is a new form of lipoid pneumonia that either didn’t exist – or hadn’t yet been identified – before 2019. It occurs when oily deposits collect in the lungs, and the body then begins to attack those deposits as if they were pathogens.

EVALI is an extremely severe lung ailment, and many of the people who have contracted it have required emergency medical intervention including systemic steroid administration, supplemental oxygen and ventilator support.

At least 48 patients have died, and the long-term health outlook for those who have survived the illness is unknown. 

EVALI has occurred almost entirely in the United States. A few cases have been reported in Canada.

What Causes EVALI?

As of December 2019, the Food and Drug Administration hasn’t identified a single substance or contamination as the root cause of all EVALI cases.

However, THC has been found in most of the product samples submitted to health authorities, and of those, most contained oil-based diluents and thickeners.

The most common diluent found was Vitamin E acetate, followed by MCT oil and polyethylene glycol. Oil-based diluents are not used in commercial nicotine e-liquids, but they are very common in THC vaping products.

There are some EVALI patients, however, who have continued to maintain that they never used THC vaping products prior to the onset of the illness. Health authorities continue to investigate both THC and nicotine vaping products.

Why Is the Media Focusing Negatively on E-Liquid Vaping?

In the United States, the FDA has regulated the e-liquid vaping industry since 2016. E-liquid makers have not been allowed to release new products or to change the formulas of their existing products without first applying to the FDA for permission. No company has yet received permission to market a new e-liquid product, so the U.S. e-liquid industry has remained stagnant since 2016.

EVALI, meanwhile, is a new phenomenon. All signs suggest that the cause of EVALI is some form of vaping that’s illegal or unregulated – THC vaping, in other words.

In spite of that fact, the U.S. media has used EVALI as an excuse to write about e-liquid vaping in a negative light. That could be because Big Tobacco and Big Pharma companies are major advertisers and lobbyists, and those companies would like to see vaping – a great threat to their businesses – disappear.

It could also be because one vaping brand – JUUL – has become incredibly popular among teens, angering parents and politicians alike. JUUL, however, is a Big Tobacco brand that does not represent the larger vaping industry.

How Can I Vape E-Liquid Safely?

No commercial nicotine e-liquid product has been implicated as a cause of EVALI. It’s still wise, however, to ensure that you buy e-liquid only from trusted vendors.

The possibility that any commercial nicotine e-liquid has caused EVALI is extremely remote because, as stated above, e-liquid makers have not been allowed to change their formulas since 2016. 

There is one form of nicotine e-liquid that exists in an unregulated space, however, and that is counterfeit e-liquid. JUUL is America’s most popular vaping product, and that’s the brand that makers of fake pods will target.

In 2019, JUUL stopped selling most of its pod flavors in the United States. If you find Mango, Cucumber, Fruit or Crème JUUL pods in a store, there is a strong possibility that those pods are fake and could potentially contain unknown contaminants. As of December 2019, the only flavors that JUUL still sells in the United States are Virginia Tobacco, Classic Tobacco and Menthol. 

How Can I Vape Cannabis Safely?

If you use cannabis by vaping it, the wisest strategy is to buy products only from a licensed dispensary and not from private sources.

Even if you do buy from a dispensary, it’s smart to avoid liquid vaping products such as pre-filled cartridges because you can’t know whether a cartridge contains Vitamin E acetate, MCT or other oil-based diluents unless the cartridge has been tested by a laboratory. 

Whether you buy cannabis privately or from a dispensary, the safest option is to buy only whole flowers until health officials identify the cause of EVALI, and new cases begin to decrease.

If you do buy cannabis privately because legal dispensaries are not available to you, it is imperative that you avoid all liquid THC vaping products regardless of what your supplier tells you.

While the exact cause of EVALI may be unknown, it is known for certain that illegal THC vaping cartridges have caused most cases of the illness.