Tobacco

CDC Further Links Vape Illnesses to Thickening Agent

Agency says outbreak separate from increase in underage vaping
Photograph: Shutterstock

ATLANTA Federal health agencies have drawn a stronger connection to last fall’s outbreak of lung illnesses and deaths related to vaping to the use of vitamin E acetate, sometimes used as a thickening agent in products containing tetrahydrocannabinol (THC), with the relationship a separate matter from the increase in underage vaping, officials said.

In its February 2020 cover story, CSP magazine editors say sources allege that state and federal health officials last fall would often speak of the outbreak and the youth-vaping issue as related matters, which may have led to at least eight states enacting bans on flavored vaping. In the same period, the federal government raised the minimum age for purchasing tobacco products from 18 to 21 and the U.S. Food and Drug Administration (FDA) announced it would use its enforcement powers to temporarily remove flavored vaping cartridges, excluding tobacco and menthol flavors, from the market.

In a Jan. 17 press release, the Centers for Disease Control and Prevention (CDC), Atlanta, cited a new report published in the New England Journal of Medicine that called the outbreak of lung-illnesses that began last summer and peaked in September 2019 “distinct” from the ongoing epidemic of e-cigarette product use among U.S. youth.

The CDC statement said, “The … outbreak primarily affects young adults, is driven by the use of THC-containing products from informal sources and is strongly linked to vitamin E acetate. In contrast, the youth e-cigarette, or vaping, product use epidemic primarily affects adolescents, is driven by use of nicotine-containing products obtained mostly from formal sources and has been caused by multiple factors, including advertising, attractive flavors—particularly in cartridge-based products—and the availability of easily concealable devices that deliver high levels of nicotine.”

Initially, the CDC and other federal health officials held a press conference in early September to talk publicly about the outbreak. The agency did not make a major announcement about the connection to THC, the psychoactive element in marijuana, and vitamin E acetate, until two months later. In that time, Massachusetts, Michigan, Montana, New York, Oregon, Rhode Island, Utah and Washington enacted some form of vaping restriction, with New Jersey taking action in January.

Since the November announcement tying the lung illnesses to THC and vitamin E acetate, the CDC pointed to at least seven new studies showing the connections between those elements. “These reports build on the continued scientific progress CDC and our partners have made to reduce the number of [lung illness] cases,” said Robert Redfield, a director with the CDC. “It is also critically important that we continue to do all we can do to protect Americans—particularly young people—from this serious health threat.”

In its January statement, the CDC said that along with the FDA, the two agencies recommend that people not use THC-containing e-cigarette, or vaping, products, particularly from informal sources.

Vitamin E acetate should not be added to any e-cigarette, or vaping, products, the agencies said. Additionally, people should not add any other substances not intended by the manufacturer to products, including products purchased through retail establishments.

The agencies also recommended that ex-smokers now vaping should not go back to smoking and that young people and pregnant women should not use vaping products.

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