Vaping and Your Health

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Since August 2019, health issues surrounding vaping products have risen across the nation. Unfortunately, current data indicates the majority of cases appear to originate from unsafe, untested, illegal cannabis vape cartridges that were not purchased in licensed cannabis dispensaries. Nicotine vaping products (e-cigs) are also to blame and together these bad actors cast dark shadows across the entire regulated cannabis community. Consequently, you’re not alone if you have concerns about vaping and your health. To make matters worse, government agencies and most media outlets are using a blame everyone approach by not identifying illegal products as the source of the outbreak.


It’s critical that we remember the terrible reality that people died or were seriously injured, however the solution is not a complete ban on all vaping products – like Massachusetts. Many other states and local governments are considering evoking bans of varying degrees. While this may seem like a good immediate option, the medium to long term consequence could actually make things worse. Making vape products illegal will push them to the black market where they can’t be regulated and made safe for consumption. If anything, the situation demands more regulation, testing and licensing. In addition, increasing regulation ensuring that products are only sold through licensed cannabis retailers. As a side note, the products sold by licensed retailers did not cause the problem.


Facts from the Centers for Disease Control and Prevention


  • As of October 8, 2019, 1,299 lung injury cases associated with the use of e-cigarette or vaping products have been reported in 49 states, the District of Columbia, and one U.S. territory.
  • The outbreak has a name; EVALI, which stands for e-cigarette vaping product use associated lung injury.
  • Twenty-six deaths have been confirmed in 21 states.
  • 76.9% of victims said they used THC and 56.8% reported using nicotine.
  • 36%, said they exclusively used THC while 16% said they only vaped nicotine.
  • 70% of patients are male.
  • The median age of patients is 24 years and ages range from 13 to 75 years.
  • 80% of patients are under 35 years old.


The CDC reports that most affected patients have a history of using THC products. However, it stated that products “obtained off the street or from other informal sources (e.g. friends, family members, illicit dealers), are linked to most of the cases and play a major role in the outbreak.” Yet in a complete departure from this fact, the CDC recommends that “you should not use e-cigarette or vaping products that contain THC.” Following this line, the FDA is not providing helpful advice when it broadly states “Do not use vaping products that contain THC.”


Cannabis Associations Endorse Strong Regulation


Again, the core problem is that the harmful vape products were illegal and in some cases, counterfeit versions of popular, legal, and tested brands. The National Cannabis Industry Association (NCIA) took action by sending a formal letter to each member of Congress signed by more nearly 800 business leaders, advocates, and policy experts urging Congress to remove cannabis from the Controlled Substances Act and create a national regulatory framework. The California Cannabis Industry Association (CCIA) is working with retailers, the California Department of Public Health, state, and local authorities to facilitate a collaborative response with the industry, aide in investigations, and ultimately protect public health from the illicit cannabis market. The CCIA is also empowering legitimate retailers to inform their customers and patients on how to spot and avoid counterfeit products.


The National Organization for the Reform of Marijuana Laws (NORML) Deputy Director Paul Armentano said: “These unfortunate incidents reinforce the need for greater regulation, standardization, and oversight of the cannabis market — principles which NORML has consistently called for in the cannabis space. Consumers must also be aware that not all products are created equal; quality control testing is critical and only exists in the legally regulated marketplace.”


Alex Gordon, Director of Product Development at vape manufacturer The Kanvas Company agrees with NORML’s position. He further explained that some low quality, Chinese vape hardware containing heavy metal contamination may also be to blame. In contrast, his company’s products are made from high-quality, food-grade stainless steel components. “We work with two certified testing labs for accurate comparative analysis on our hardware. We also have a very tight quality control process for our vendors and supply chain” Alex said.


Buying Safe Cannabis Vaping Products


The illness outbreak does not appear to originate from one company (like the Johnson & Johnson’s Tylenol tampering case in the early 1980s) and investigators have not determined a uniform cause or tied it to a single ingredient. Initial reports find that carrier agents such as Vitamin E Acetate or MCT Oil (among others) added to the oil cartridge may play a crucial role. Vitamin E becomes toxic when heated and inhaled, creating conditions similar to pneumonia. Some physicians have also described the effects as similar to chemical burns in the lungs.


To its credit, NBC News recently conducted an investigation and reported that products purchased from legal dispensaries in California did not contain heavy metals, pesticides or residual solvents like Vitamin E Acetate. NBC utilized the certified testing lab CannaSafe and out of twelve illicit products it tested, CannaSafe reported:


  • Nine products contained Vitamin E Acetate.
  • All had detectable levels of illegal pesticides, including myclobutanil, which when heated turns into poisonous hydrogen cyanide.
  • Seven of the products made false THC claims.


It is also critically important to note that of the 104 legal vape products CannaSafe tested, none contained Vitamin E Acetate or illegal pesticides.


The cannabis market research company Headset recently released data showing the vape pen market “significantly decreased in all states starting the last week of August, when the first illness cases were reported, then stabilized in California, Nevada, and Washington during the latter half of September. In fact, moving forward, we could see vape pen sales increase if consumers in adult-use states move their purchases from the black market and into licensed dispensaries where they can be confident they will be able to purchase fully regulated and tested products.”


Clearly, the combined messaging from the legal cannabis community is for consumers to purchase legitimate, tested, and safe products from licensed retail dispensaries. Most states with legal cannabis dispensaries created a retailer database so consumers can see whether their dispensary is licensed. Going a step further, and while requirements may vary from state to state, the CCIA offers this advice for inspecting a vape product if you’re unsure about the dispensary or the product’s legal status:


  • Does the product use childproof packaging?


  • Is there a Track & Trace batch number?


  • Does the packaging have the required Testing Symbol?


  • Does the packaging contain manufacturing and packaging dates?

Looking Forward


For many consumers, vaping cannabis oil is an efficient and discreet way to consume cannabis. It plays an important, sometimes critical role in providing needed medicine to patients. The ramifications of the current health issue reach far and wide across the cannabis community. It also provides ammunition to anti-cannabis forces who seek to halt cannabis legalization at all levels. They dismiss the medicinal benefits of cannabis while conveniently not mentioning that tobacco (a legal product) causes more than 480,000 deaths per year in the United States or 1,300 deaths every day according to the CDC. The opiate epidemic has also killed tens of thousands of Americans. It is with great sadness that a few unethical, underground cannabis manufacturers put profits over people. Cannabis, for the first time, is now associated with injuries and even death. It is a stain that affects everyone who supports access to safe, regulated medicinal and adult-use cannabis vaping products.


The investigations will continue, hopefully leading to product confiscation and the arrest and conviction of the perpetrators. In the meantime, everyone in the legitimate cannabis business has an obligation to help educate the public about the benefits of buying legal cannabis products, as well as the dangers of illegal cannabis vaping products. As the CDC noted, 80 percent of the victims were under age 35. Help spread the word and educate everyone that buying an illegal vape is simply not worth the potential long term costs to your health. I say, #BuyLegal.


Philip Rebentisch is a Contributing Editor to Three Wells. He is also the host of the podcast Cannabis For the Rest of Us sponsored by Three Wells. Find it on Apple PodcastsGoogle Play, or Stitcher.

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