CDC Admits Illegal THC Vapes Are Primary Cause of EVALI

In 2019, vaping didn’t have its greatest year. In the United States, a new lung condition called E-Cigarette or Vaping Product Use Associated Lung Injury – or EVALI – appeared. More than 2,700 people in the U.S. contracted the debilitating lung illness, and all patients stated that they had used vaping products prior to the onset of symptoms. More than 60 people didn’t respond to treatment and ultimately died.

EVALI quickly became a worldwide news phenomenon, with most media outlets simply using the term “vaping” – with no further clarification – when reporting on it. Most publications completely ignored the fact that vaping comes in two forms. People can vape nicotine e-liquid – which is legal for adults throughout the United States – and they can vape THC-containing hemp extracts, which is legal in some states but illegal according to the federal government.

Guess which form of vaping causes EVALI?

Experts Sounded the Alarm on THC Vapes Early

Immediately, people who understood vaping – including former FDA commissioner Scott Gottlieb – knew that the chance of the illness being caused by legal nicotine e-liquid was remote. Here’s why.

• Aside from a few isolated cases, EVALI has only occurred in the United States. Most of the nicotine e-liquids used in the U.S. are also available throughout the rest of the world.
• The EVALI outbreak occurred in 2019, but the vaping industry in the U.S. has been regulated by the federal government since 2016. Since that time, e-liquid makers have not been allowed to change their formulas.
• The symptoms of EVALI – and the lung damage caused by it – were consistent with the inhalation of oil. Nicotine e-liquid contains no oil.

Despite the obvious evidence that EVALI must have something to do with illegal THC vapes, news outlets knew that it would drive more clicks and more page views if they conflated nicotine and THC vaping when reporting on the illness. Parents – particularly in the United States – were already afraid that their children would start vaping. The idea that vaping could potentially be deadly only sparked further outrage. Media outlets were only too happy to stoke the flames if doing so increased readership.

EVALI Harmed the Vaping Industry and Public Health

Irresponsible news reporting on EVALI caused immense harm both to the vaping industry and to public health around the world. Many smokers who might have switched to vaping decided against making the switch and are probably still smoking today. It’s likely that some vapers even read about EVALI and decided to return to smoking. While the vaping industry did continue to grow, the rate of growth became slower than it had been in several years.

How bad was the media’s inaccurate conflation of nicotine and THC vaping for public health? In 2020, Morning Consult conducted a survey of 2,200 American adults. Here are the results of that survey:

• 41% of those surveyed incorrectly believed that THC-containing products did not cause EVALI.
• 66% of those surveyed incorrectly believed that nicotine-containing e-cigarettes did cause EVALI.
• Just 28% of those surveyed correctly believed that THC-containing products did cause EVALI.

The fact that the false fear of EVALI was causing so many smokers not to consider vaping as an alternative prompted Public Health England to issue a press release on 4th March 2020 reassuring the citizens of the United Kingdom that e-liquid vaping was less harmful than smoking and did not cause EVALI.

What Are the Current Medical Findings on EVALI?

In 2020, the U.S. Centers for Disease Control and Prevention finally issued a press release clarifying that EVALI is caused by THC vaping products and not by legal nicotine e-liquids obtained through formal sources. The press release stated the following:

• 82% of EVALI patients had used THC products.
• Only a very small percentage of EVALI patients reported that they had only used nicotine e-liquid and were not found to have THC metabolites in their systems.

While the CDC found that the few incidents of EVALI in patients who were not known to have used THC vaping products merited further study, the press release concluded that EVALI was “driven by the use of THC-containing products” and was “strongly linked to vitamin E acetate,” which was commonly used as an additive in illegal THC vapes.

How to Ensure That You Always Vape Safely

Based on the research that has been conducted to date, no legal nicotine e-liquid has ever been implicated as a cause of EVALI. Despite that fact, there remains the question of the EVALI patients who are not known to have used THC vapes. If those people only used nicotine e-liquid, how did they contract the lung illness? We can think of two plausible explanations.

• It is possible that some or all of the patients who claimed not to have used THC vaping products were lying and were either not tested or had no detectable THC metabolites in their bodies when they were tested. Since marijuana is illegal in the United States according to federal law, it’s likely that some THC-using EVALI patients were reluctant to disclose their use.
• Counterfeit versions of legal vaping products are also a major concern. That’s particularly true of JUUL, the world’s best-known vaping brand. It’s been reported that factories in China are producing more than 10 million fake JUUL pods per month. Since most JUUL pod flavours are banned in the United States, the U.S. is the biggest market for those fake pods. Any e-liquid produced without regulatory oversight is potentially dangerous.

So, what can you do to ensure that you can always vape safely? Based on all available information, we can offer the following suggestions.

• If you use cannabis, you should avoid all pre-filled liquid THC vaping products – even those purchased from legal dispensaries. In the United States, vitamin E acetate has been found even in some dispensary-sold THC vaping products. The safest option is to buy whole flowers only.
• Buy nicotine e-liquid only from trusted sources to ensure that you won’t end up with counterfeit products. A high-quality vape shop will buy its products only direct from the manufacturers or from major distributors.