USA health officials are looking closely at vitamin E acetate as a potential cause of the severe lung injuries that have sickened thousands of Americans who have used vaping devices, including more than three dozen who died as a result.
Vitamin E acetate, which is used in food and skin care products without adverse effects, is used as a cutting agent or additive on the cannabis black market because it is colorless, odorless and low-priced, and has a consistency similar to THC oil. The CDC has said that in a small percentage of confirmed illnesses, patients had reported using nicotine-only products.
Anne Schuchat, the CDC's principal deputy director, said tests have been conducted for a wide variety of substances, including plant oils and petroleum distillates.
On Friday, President Donald Trump said he will move to increase the legal vaping age as early as next week, while also backpedaling on a previous announcement to consider banning flavored e-cigarettes.
Health officials believe the dead and injured patients used psychoactive THC-containing liquids bought off the black market that were diluted with a common chemical additive that, under vaping conditions, becomes risky.
"These results are unacceptable and that is why we must reset the vapor category in the USA and earn the trust of society by working cooperatively with regulators, Attorneys General, public health officials and other stakeholders to combat underage use", K.C. Crosthwaite, CEO of Juul, said in a statement. But "in those that were tested so far, it's primarily been [in] THC-containing e-liquids". Finding THC in 82% of samples is "very noteworthy", but on the flip side, not finding it in 18% of samples is "very explainable", said Dr. Jim Pirkle of the CDC's Environmental Health Laboratory during the news conference.
He described vitamin E Acetate as "oily - not kind of a common oil, but it's an oily substance". So when it goes into the lung "it does hang around".
Vitamin E acetate is widely used in food and skin-care products, where it is safe, Schuchat said. Vitamin E acetate has been highlighted as a huge concern by proponents of vaping for months, and once people began falling ill it seemed like the most likely culprit. "These findings provide direct evidence of vitamin E acetate at the primary site of injury within the lungs".
Scientists theorized that the oil might be coating the lungs, triggering inflammation and damage. THC was found in 23 of the lung fluid samples, which came from 10 states, that were tested by the CDC.
The agency's analysis of 29 samples from the e-cigarettes used by people with the mysterious lung illness revealed that they all contained vitamin E acetate. "There may be more than one cause of the outbreak", she said. Another MMWR report published today, found through a survey conducted in IL, that patients who had EVALI were about nine times more likely to have gotten their products from informal sources such as a friend, a family member or the black market.