By Kellen Brent Pierce
Well, it’s official — vapes are no longer the safe alternative to cigarette smoking. We now know that electronic cigarettes/e-cigs/vapes can kill you, and in a much quicker fashion than traditional smoking habits. And we know how; we just don’t know why.
On Monday, a seventh death since July was linked to e-cigarette use. The CDC now counts 380 cases with either a confirmed or probable link to e-cig use, with an additional 70 possible cases. It would appear that America is in the middle of its first e-cigarette epidemic — 12 years after the product was introduced.
Why only now, and why so suddenly?
Justin Amesbury is Director of Research and Development at Lazarus Naturals, a national, market-leading manufacturer of what the company calls “consciously crafted CBD”. Lazarus Naturals are sold throughout the country, even here in Alaska. Via email, Amesbury says, “While there is no definitive root cause, one potential culprit that has been identified is the presence of Tocopheryl acetate, also known as vitamin E acetate or vitamin E oil.”
Amesbury says that while Vitamin E is safe when applied topically or orally as a diet supplement, its large, fat-soluble molecules are bad news when inhaled.
“When a large, lipid-based molecule is inhaled, the particles stick to and begin accumulating in the lungs. The accumulation of these particles results in an inflammatory reaction in the lungs,” Amesbury says. “This lipid-induced, inflammation of the lungs is known as lipoid pneumonia and can lead to symptoms ranging from chronic cough and difficulty breathing to severe chest pain and expulsion of blood from the lungs.”
Vitamin E oil has been found in nearly all of patients’ cannabinoid e-cigs tested so far, but it hasn’t been confirmed to be the only cause, as some patients reported only using nicotine devices, though the FDA reported finding nothing unusual in those devices tested so far.
In late August, Rolling Stone published a report claiming that vitamin E oil was an additive being used by counterfeit manufacturers on the black market to cut their THC product. On Monday, two brothers were arrested in Wisconsin for conducting what authorities are calling the largest counterfeit THC cartridge operation they have ever seen. Twenty-year-old Tyler Huffhines told police that while he initially bought cartridges in California and smuggled them back to Wisconsin for profit, he discovered that if he bought empty carts and filled them himself, he could maximize his earnings. The dark jar of purported THC liquid found in his apartment is currently being tested for a match to those brought in by the 27 hospitalized e-cig users. Hoffhines says he was producing three to five thousand fake cartridges every day.
While there have been cases of respiratory illness in 36 states, Alaska has not been one of them. Via email, AMCO Chair Erika McConnell assured that the agency “is reviewing all approved vaping products to identify those that have non-marijuana additives,” and that “only vaping products containing marijuana that are manufactured by licensed manufacturing facilities are approved by the Marijuana Control Board.”
McConnell doesn’t believe that the state had previously approved any products with vitamin E acetate, and until we hear about somebody gasping for life at Providence, I’m willing to bet that there aren’t any for sale in Alaska — at least not at your local head shop.
Lazarus Naturals’ Amesbury general rule for quality discernment echoes AMCO’s approval method. “In the cannabis space it is entirely possible to produce a vapeable product without employing cutting agents of any sort,” Amesbury says, “so those products along with traceable batches and corresponding test results represent the lowest risks to cannabis consumers.”
However, although the science appears to point to a specific ingredient type (fat-soluble oils) and a specific supplier type (unregulated, black market cartridges), the federal government isn’t letting facts get in the way of any ham-handed opportunism.
On September 11th, President Donald Trump announced that his administration would be moving forward with a ban on all flavored nicotine e-cigarettes. In the announcement, POTUS invoked the perennial “children” — specifically, the youngest Trump, 13-year old Barron. This ban has been over a year in the making, but the current public-health panic is the perfect subterfuge under which to slip in some pre-written, overreaching legislation, kind of like the Patriot Act, which makes the 9/11 coincidence all the weirder.
The first e-cigarette was developed in China in 2003. In 2006, the product was introduced to Europe, and in 2007, the U.S. Ten years later, a study published last year in the Annals of Internal Health found nearly 11 million adults used e-cigarettes. In fact, the utter ubiquitousness of electronic cigarette use was what partially led lawmakers to push for a federal ban in 2018.
The FDA was handed regulatory authority over tobacco in 2009 when President Obama signed the Family Smoking Prevention and Tobacco Control Act. After that legislation was passed, former Philip Morris executive Steven Parrish sent a congratulatory email to former FDA Commissioner David Kessler. Philip Morris had notoriously fought against FDA regulation until Parrish had a sudden change of heart and encouraged cooperation, allowing the company an opportunity to influence the legislation.
Ten years ago, the New York Times wondered in print if Philip Morris knew something that we didn’t.
Fast forward ten years to a federal ban on all e-cigarette devices until they can pass FDA approval — guidelines to which were only published in June. Today, there is only one e-cigarette–type product to ever make it through the labyrinthine regulatory process: IQOS, owned and developed by Philip Morris International.
If the FDA immediately bans unapproved e-cigs, the company will stand alone in the American market. The nearest runner-up in approval hopes is Juul, which sold 35% to Altria last year. Prior to 2003, Altria was known by its previous name, Philip Morris USA.