CDC cites additive in vaping deaths

There have been 60 vaping-related deaths in the United States since 2019, but the danger appears to be related to an additive used in illicit TCH-infused cartridges rather than an inherent danger in vaping, the US Centers for Disease Control and Prevention (CDC) now believes.

The latest research led the CDC to back off from its prior recommendation that everyone stop vaping while scientists investigate the cause of a nationwide outbreak of lung illnesses related to the practice.

In new guidance posted on the CDC's website on Jan 17, the agency says young people, pregnant women and non-smokers should continue to refrain from vaping but deleted a general recommendation that everyone avoid the practice.

"Recommendations were refined to reflect the best available scientific evidence and to best protect public health," Brian King, CDC's chief science officer for the vaping-related illness outbreak, said in a statement.

Investigators have found the sharp increase in the number of vaping-related illness is linked to vitamin E acetate, an oil sometimes added to THC-infused products as a thickening agent.

When ingested in many foods, including, cereal, meat, fruits and vegetables or as a dietary supplement, Vitamin E is safe. But when inhaled through a vaping device, it may interfere with normal lung functioning, the CDC said.

Tetrahydrocannabinol, generally called THC, is the psychoactive ingredient in marijuana that gives users a "high" or "buzz". The CDC warns vapers not to use cartridges obtained from "informal" sources such as friends, family and online dealers because product purity cannot be assured.

Electronic cigarettes, also called vape pens, tank systems, e-hookahs and electronic nicotine delivery systems, heat a liquid to produce an aerosol that users inhale to deliver nicotine or THC. Vaping thereby avoids the toxins created by burning tobacco or the paper wrapping in cigarettes.

"However, evidence is not sufficient to rule out the contribution of other chemicals of concern, including chemicals in either THC or non-THC products," the CDC warned.

Officials trace the outbreak of vaping-related illness to 2019. Researchers quickly discovered that most patients who developed lung problems obtained THC-infused products from unregulated sources. Sixty-two percent of the patients were age 18 to 34. Two-thirds of those hospitalized were male.

Through Jan 14, the CDC reported 2,668 people in all 50 states plus the District of Columbia, Puerto Rico and the US Virgin Islands had been hospitalized. Deaths have been reported in 27 states, including California, New York, Massachusetts and Texas. The median age of deceased patients was 51 and ranged in age from 15 to 75.

While new cases continue to be reported, the CDC said the outbreak peaked in September 2019, and the number of new patients reporting vaping-related illnesses continues to decline. Reasons for the drop aren't fully understood, but researchers believe more people are heeding warnings to avoid THC-infused products and may be more cautious about vaping as word of lung problems spreads.

The number of vaping-related illnesses and the rise in teen vaping has led to increased state regulation and a public backlash against vaping — especially the sale of mint- and fruit-flavored nicotine products that appeal to youths.

The CDC urges teenagers to avoid vaping but warned that the problems of youth vaping and lung injury from THC-infused products are separate and therefore should not be conflated.

In September, US President Donald Trump announced plans to pull most vaping products from retailers' shelves as public concern mounted. But the US Food and Drug Administration (FDA) earlier this month backed off a general ban and exempted tank systems generally available at vape shops from the ban on fruit-flavored products.

Nevertheless, the CDC said it will continue to collect data on vaping-related illnesses. The agency continued to urge smokers to quit and advised those who do not vape to avoid the practice.

"Adults using nicotine-containing e-cigarettes or vaping products as an alternative to cigarettes should not go back to smoking," the CDC said. "They should weigh all available information and consider using FDA-approved (smoking) cessation medications."