American Vaping Association: Facts on Lung Illnesses and Deaths “Associated with Vaping”

As of September 6, the Centers for Disease Control and Prevention (CDC) reported over 450 cases of severe lung disease possibly associated with the use of "e-cigarettes." Among these cases, three types of lung injuries were identified, including: lipoid pneumonia, pulmonary hemorrhage, and idiopathic organizing pneumonia.

As of September 10, 2019, six deaths have been reported.

a) Illinois (reported August 23)—no details available

b) Oregon (reported September 5)—a middle-aged patient who used THC oil purchased from a legal pharmacy, but it cannot be guaranteed that he did not also use illegal THC cartridges.

c) Indiana (reported September 6)—no details available

d) Minnesota (reported September 6)—a person over 65 years old who used illegal THC products.

e) Los Angeles, California (reported September 6)—no details available, but according to the Los Angeles Times, "almost all of the 12 hospitalized in Los Angeles County used THC oil"

f) Kansas (reported September 10)—no details available.

Should we be concerned about e-cigarette users who use nicotine e-liquids?

In short, no. Evidence continues to indicate that low-quality street vaping products containing THC or other substances are the main culprits behind these illnesses.

Adult smokers using store-bought nicotine vaping products to quit or reduce smoking should not be scared off by these incidents, nor should they be misled into thinking that reverting to traditional tobacco is a better choice than using e-cigarettes.

What have tests revealed?

On September 5, the New York State Department of Health reported that laboratory test results indicated "almost all cannabis-containing samples had high levels of vitamin E." In this testing, each patient submitted their vaping devices, and at least one of their devices was found to contain vitamin E acetate, which is used as a thickening agent in illegal products.

On September 6, Mitch Zeller from the FDA's Center for Tobacco Products stated at a CDC press conference: "We are continuously evaluating all samples, and no single substance or compound has been identified, including vitamin E acetate."

According to the Washington Post, the FDA notified state health officials on September 4 that its laboratory tests of nicotine products "showed no abnormalities." The FDA has not made this public yet.

Does the FDA condemn nicotine vaping products?

The CDC has urged all Americans to consider not using vaping products and not to purchase vaping products from the street, but the agency has been criticized for not clearly pointing out the dangers of illegal THC products (including our criticism).

Hours after the CDC's press conference on September 6, the relationship between the FDA and CDC "broke down," and the FDA specifically warned about the dangers of THC vaping products.

Are young people misreporting their THC use?

In every state that has released detailed data, the vast majority of patients or all affected patients reported using illegal THC products. Nevertheless, CDC officials and public health advocates continue to warn about vaping products, basing their warnings on a few patients who only used nicotine vaping products.

Dr. Melodi Pirzada, a pulmonologist at NYU Langone Hospital, treated two patients who used THC vaping products and told reporter Foster Winans about one 18-year-old male case. "We conducted millions of dollars in tests and could not figure out the cause. He denied using vaping products until his family found a device containing cannabis oil in his bedroom, and then we learned that his symptoms began when he started using it."

Lena Sun from the Washington Post has spoken with many state health officials and doctors who have treated patients in this area, and they have similar feedback: "Patients, especially teenagers, are often reluctant to disclose whether they have used cannabis products."

Dr. Ngozi Ezike, director of the Illinois Department of Public Health, stated: "Not everyone admits to using THC oil. We cannot determine whether that is because they are afraid to admit it or because they have never used it."

Cannabis remains illegal at the federal level and in most states, and given that patients tend to be younger (the average age of patients in Illinois and Wisconsin is 19), it is reasonable that some or all patients may be reluctant to disclose their entire vaping history after their parents and police get involved in the investigation.

What are state and local health departments saying?

New York: As of September 6, 2019, the New York State Department of Health reported receiving 38 reports from New York doctors regarding severe lung diseases, with patients aged 15 to 46, and all had used at least one cannabis vaping product before becoming ill. The department also specifically warned that "using black market vaping products may lead to lung disease."

Wisconsin: At the end of August, Wisconsin reported that 89% of their cases (24 out of 27) admitted to using THC vaping products. As of September 5, Wisconsin had reported 34 cases and issued a specific warning: "We urge the public not to use any THC vaping products."

Los Angeles, California: On September 6, the Los Angeles Times reported that "almost all" of the 12 reported cases in Los Angeles involved THC vaping products, and the Los Angeles Health Department issued a warning against using any vaping products.

Kings County, California: In August, the Kings County Health Department warned against using THC or CBD e-liquids after seven cases of acute respiratory distress syndrome appeared locally. As of September 5, the number of sick individuals had increased to nine.