Almost a hundred patients began arriving at Wisconsin and Illinois emergency rooms last spring, say the state public health officials who led the study. Most were healthy young men who said they vaped at least once a day. Two died, while the rest averaged a week in the hospital.
Hospitalizations of more than 2,700 people have been reported across the country in connection with vaping. Sixty have died. The injuries were like those seen in poison gas victims. Medical studies suggest that the culprit in most cases is vitamin E acetate, a chemical recently adopted by some illegal manufacturers to dilute the cannabis in their vape cartridges.
While those findings may reassure users of legal cannabis vapes or nicotine e-cigs like the Juul products of Altria Group (ticker: MO), Illinois public health physician Jennifer Layden and her co-authors advise caution while research continues.
“The best way for persons to ensure that they are not at risk,” the researchers say, “is to consider refraining from the use of all e-cigarette, or vaping, products.”
The hospitalizations last summer slowed the fast growth of legal cannabis sales in the states that allow products containing the weed’s intoxicant THC. Licensed producers sought to demonstrate that their vape products were tested and free of vitamin E acetate. Altria, meanwhile, has been fighting health-related lawsuits over its Juul products.
Altria did not immediately respond to a request for comment.
Nicotine e-cigs were less frequently associated with last year’s outbreak of acute lung injuries, but Wednesday’s study in the New England Journal reports that 11% of the examined patients said they had been using only nicotine products. Some of that association with nicotine may be a bum rap, say the authors, since “patients may be reluctant to report illicit drug use.”
It is striking how many patients used cannabis and e-cigs—60% of the studied patients said they used both, including 27 different brands of cannabis vapes and 25 brands of nicotine products.
And nicotine vaping isn’t free of worries, notes David Christiani, a Harvard public health researcher in an editorial that accompanied Wednesday’s study. E-cigarette fluids have been found to contain seven types of toxins, he warns, and have demonstrated damage to lung cells.
Despite surging e-cig use among teens, regulators haven’t required e-cig manufacturers to report all their products’ ingredients or prove their safety. That’s a risk, Christiani believes. “The burden should be on the nicotine vaping companies to prove that their vaping fluids do not contain pulmonary toxicants,” he wrote.
Until there is evidence to clear suspicion from the 11% of lung injury cases associated with nicotine vapes, Christiani says, people trying to quit smoking should use non-vape nicotine substitutes.
Write to Bill Alpert at email@example.com