Investigations into the recent rash of lung illnesses have only recently begun. The CDC and FDA are issuing conflicting reports, while much of the media reports have misinterpreted the scant data that has become available. 

Certainly these incidences are troubling and have caused those who enjoy vaping and e-cigarettes some concern, and it is important to understand the facts, the speculation and the most likely cause of these serious health issues. 

According to an in-depth report from Vapor Authority, there is a serious conflict between recommendations from the CDC and the FDA. The CDC’s most recent report, while noting that it is “too early to pinpoint a single product or substance common to all cases,” still offers a mix of advice that ranges from the useful to the unfounded. Most appropriately, the agency suggests that people should never buy e-cigarette products or vape liquids off the street, and should not modify them or add substances that are not intended by the manufacturer. However, their advice that “people should consider not using e-cigarette products” is off the mark, and the CDC itself admitted in a recent press conference that “no definitive cause has been established.”

By all accounts, the instances of lung illness are not the result of people using legitimate vape devices and liquids according to the manufacturer’s guidance, but rather, the result of people buying bootleg vapes, mixing their own, or adding ingredients that were not intended. 

Another telling comment from the CDC study indicates that most patients reported use of THC-containing products such as cannabis oils. That is not to say cannabis by itself causes lung disease, the fact is, cannabis, which is still illegal on the Federal level, is still largely unregulated, as opposed to vaporizers, which are legal and regulated, with most legitimate providers maintaining their own in-house testing labs for quality control. 

Vitamin E acetate is a carrier oil sometimes used by do-it-yourselfers and in bootleg vape products, and often is contained in cannabis oils and other cannabis products. Numerous reports point to this carrier oil, and not the vape juices, vape devices, nicotine juice, CBD or cannabis, as the likely candidate for the lung illness. 

The most recent data shows that 83 percent of patients were men with an average age of 19, and 84 percent of those patients used some variety of THC product. The noninfectious pneumonia, or lipoid pneumonia, which is behind the epidemic, occurs when certain oils or lipids enter the lungs. Studies from the New York State Department of Health point out that the illnesses are likely caused by exposure to a chemical found in many illicit vaping liquids and cannabis oils, most likely vitamin E acetate. While mainstream vendors who maintain testing labs seldom use this substance, it is more often used in homemade vape juice and homemade THC cartridges as a thickening agent. The New York State Health Commissioner reported that the vitamin E acetate was found in most cannabis-containing samples tested by the state in high levels, but it was not found in the nicotine-based vape products tested by the state. 

If you are interested in home brewing, stick to making beer. YouTube contains hundreds of videos with instructions on cooking your own THC liquids for vaping, and none of these methods are safe. Many such recipes call for the use of vegetable oils, which vaporize at temperatures higher than the vaporizer produces. Many of these natural vegetable oils naturally include vitamin E acetate.

Many of the illnesses are likely caused by this type of home brewing, and most likely, by brewing up unregulated vape liquids and THC liquids. The FDA’s guidance warns consumers to not vape materials containing THC – not necessarily because the THC itself is dangerous (it’s not), but because it usually contains vitamin E acetate or another carrier oil that is the most likely cause of the illness. Unfortunately because cannabis is still illegal by Federal law, the FDA does not have the authority to regulate its use and production, and the cannabis oils being used are created and overseen at the state level only, and more often, are produced by do-it-yourselfers at home who follow poor advice from YouTube videos produced by hobbyists. 

The better solution is not an outright ban, but rather, legalization at the Federal level so that the FDA can properly oversee and regulate THC oils and other cannabis products to ensure that they are processed in a legitimate laboratory environment, tested for quality and safety, and ensured that carrier oils likely to cause lung disease are not present. 

Former FDA commissioner Dr. Scott Gottlieb recently told the New York Times that “It’s not like the major manufacturers have suddenly changed their ingredients. It’s probably something new that has been introduced into the market by an illegal manufacturer.” The best advice, according to Gottlieb, is to avoid street or bootleg products. 

While anti-vaping and anti-THC advocates, along with some government agencies and the medical community, have been quick to issue a wholesale indictment against vaping, those individuals and groups have in fact jumped the gun. Their focus should be researching the true source of the illness, and conducting more research around the underlying pattern of these diseases, which is the use of illegally sourced or modified products. There is no evidence that vaping itself, vaporizers, or e-cigarettes have caused any of these incidences of lung disease. On the contrary, the evidence overwhelmingly points to the culprit being home-made illicit and bootleg THC liquids containing carrier oils such as vitamin E acetate as being directly responsible.