November 10, 2019

Stanton A. Glantz, PhD

Link between vitamin E acetate and EVLAI just got stronger

Earlier this week CDC released data showing that vitamin E acetate, a chemical used in THC and nicotine e-cigarettes, was present deep in the lungs of all 29 patients they studied.  This is important because many people have suspected that vitamin E acetate was contributing to the epidemic of serous lung injury in vapers.

Nicotine e-cigarette advocates have seized on this observation to blame the serious lung disease on THC vapes.  But, it is important to pay attention to what CDC actually said:

Vitamin E acetate was detected in all 29 patient BAL [bronchial alveoliar lavage, which yields information of what is deep in the tiny air sacks in the lungs] samples.. Among 23 patients for whom self-reported THC use information was available, 20 reported using THC-containing products. THC or its metabolites were detected in 23 of 28 patient BAL samples, including in those of three patients who said they did not use THC products. Nicotine metabolites were detected in 16 of 26 patient BAL specimens.  [emphasis added]

CDC continue to stress that, while this observation strengthens the case that vitamin E acetate is important, it does not prove that it is the only important agent.  E-cigarettes, whether THC or nicotine, deliver a wide range of toxins to the lungs, several of whom are likely contributing to EVALI and other adverse health effects.

In addition, as illustrated by the fact that nicotine metabolites were detected in most of the people, there is always the possibility that the THC and nicotine e-cigarettes are acting synergistically to increase disease risk.  CDC makes this point explicitly when they write, “it appears that vitamin E acetate is associated with EVALI; however, it is possible that more than one compound or ingredient could be a cause of lung injury, and evidence is not yet sufficient to rule out contribution of other toxicants to EVALI.”

The best advice:  Don’t vape anything.

EXTRA:  Here is interesting story in Leafly.com about the origins of vitamin E acetate and HoneyCut.

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