Federal officials said Friday the wave of vaping-related lung problems that killed more than 50 people and hospitalized thousands this year is “strongly linked” to a sticky substance used to dilute products with THC, a psychoactive chemical in cannabis.
The Centers for Disease Control and Prevention said an exhaustive investigation affirmed evidence that vitamin E acetate is the key culprit in the mysterious illnesses that rose sharply in June and peaked in September.
A study found that 48 of 51 patients with a vaping-related lung injury had vitamin E acetate in their system. The substance was not found in healthy individuals used as a comparison group.
Government researchers studied cases from more than a dozen states, meaning the illnesses probably cannot be tied to a single, local supplier with tainted products.
Separately, the CDC said it is alarmed that dozens of people had to be readmitted for vaping-related lung injuries within days of being released from the hospital, and that seven people died after being discharged. Officials said people who suffer from cardiac or pulmonary issues, sleep apnea or diabetes are at a higher risk.
Anne Schuchat, the principal deputy CDC director, said the practice of using vitamin E acetate in THC vapes “really took off this last year,” which largely explains why cases spiked.
She said the evidence suggests it is a new phenomenon tied to vaping, and not something that researchers simply missed for a long time.
The lion’s share of the cases involved THC devices obtained from informal sources — such as family or friends — or the black market, as opposed to licensed vendors, according to Dr. Schuchat.
Vaping-related illnesses killed 54 people in the U.S. and put 2,506 in the hospital this year, sparking headlines and terrifying parents — including first lady Melania Trump.
Members of Congress and President Trump, who signed a spending package late Friday that raises the purchasing age for tobacco and vaping products to 21, also fear that e-cigarettes are creating a new generation of nicotine addicts.
Mr. Trump recently convened a panel of stakeholders at the White House as he determines if a bigger crackdown is needed, such as banning on the sale of flavored e-cigarettes or walling them off from retail areas that can be accessed by underage shoppers.
The Campaign for Tobacco-Free Kids said Mr. Trump should stick to the flavor ban he teased in September, rather than settling for measures such as the age increase, which leading tobacco companies supported.
“To reverse the e-cigarette epidemic, policymakers must prohibit flavored e-cigarettes and cannot be limited by what the tobacco industry says is acceptable,” said campaign President Matthew L. Myers.
Free-market pressure groups and industry players say a flavor ban would be counter-productive. The flavored vaping industry creates jobs and adult smokers use flavored products as a substitute to regular cigarettes that are more harmful, they say.
As the federal government mulls its next steps, several states have taken matters into their own hands.
Massachusetts Gov. Charlie Baker, a Republican, declared a public health emergency in response to vaping illnesses and banned flavored tobacco, including vaping products and menthol cigarettes. After a court battle, some medical-marijuana vaporizers were carved out of the ban.
California created a $20 million digital campaign to educate children and parents on the dangers of vaping, and Missouri ordered up similar plans to create awareness.
Michigan, Montana, New York and Oregon moved toward restrictions but got tripped up in the courts, and Rhode Island and Utah have drafted restrictions.
Washington state moved in November to ban vaping products containing vitamin E acetate, as officials identified it as a concern.
Scientists aren’t sure why vitamin E acetate is harmful. It may cause a chemical reaction that damages the lining of the lungs and prevents them from expanding.
Also, heating vitamin E acetate to high temperatures appears to release a chemical byproduct, known as ketene, that injures the lungs.
“Those are two theories — potentially one or both may be operating,” Dr. Schuchat said.
The CDC and Food and Drug Administration said children should never use vaping products and that everyone should avoid THC-containing devices, “particularly from informal sources like friends, family, or in-person or online sellers.”
Dr. Schuchat warned there is a small, but consistent, set of cases related to non-THC vapes — such e-cigarettes with nicotine — so there could be other substances causing lung injuries.
“There’s a lot more work to do,” Dr. Schuchat said.
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