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Research & Commentary: Centers for Disease Control and Prevention Reports THC-Containing Devices Cause Most Vaping Illnesses

October 21, 2019

CDC finds 78 percent of patients with vaping-related lung illnesses reported using devices containing THC.

On October 15, the Centers for Disease Control and Prevention (CDC) reported “1,479 lung injury cases associated with e-cigarettes or vaping.” CDC was provided data on 1,358 patients and found 70 percent are male. The median age of the 1,358 patients “is 23 years and ages range from 13 to 75 years.”

CDC obtained information on types of substances vaped for 849 patients. Of these, 78 percent reported using vaping products containing tetrahydrocannabinol (THC) and only 10 percent self-reported “exclusive use of nicotine-containing products.” CDC notes that “national and state data suggest that products containing THC, particularly those obtained off the street […] are linked to most of the cases and play a major role in the outbreak.”

The most recent report parallels others by the CDC. On October 10, CDC found that of patients with lung-illness attributed to vaping devices, 76 percent “reported using THC-containing products,” and 13 percent “reported exclusive use of nicotine-containing products.” CDC reports on September 24 and October 3 also had similar findings. 

These reports are significant because many states have responded to recent hospitalizations by banning the sales of flavored e-cigarettes, and, in some cases, all e-cigarettes. Governors in Massachusetts, Michigan, Montana, New York, Oregon, Rhode Island, and Washington state have directed their state health departments to ban sales of flavored electronic cigarettes, and in the case of Massachusetts, a ban on all e-cigarettes went into effect on September 24. Lawsuits in Michigan, Montana, New York, and Oregon have temporarily halted the bans, but are likely to be challenged. Further, lawmakers in Connecticut, Delaware, Maine, and South Carolina are considering legislation to ban flavored e-cigarettes.

The reactionary policy of banning flavored e-cigarette products ignores the true culprit causing recent vaping-related hospitalizations: illegal and unregulated, black-market products containing THC.

Similar to CDC’s findings, many states have linked recent vaping-related hospitalizations to THC-containing products. The Utah Department of Health noted 94 percent of patients with vaping-related lung illnesses reported use of “any THC cartridges.” The California Department of Health found 81 percent of their state’s patients vaped a product containing THC.” On October 11, the Iowa Department of Public Health reported that of 38 cases of possible vaping-related lung injury, 33 patients, or 86 percent, reported vaping THC-containing devices. Similarly, Minnesota, Oregon, Texas, and Wisconsin have all linked recent vaping-related lung illnesses to the use of THC vaping products.

Although some of these states have medical and recreational marijuana programs, Iowa, Texas, and Wisconsin do not. Minnesota and Utah allow for medical marijuana. Only California and Oregon allow for recreational marijuana for individuals 21 years of age and older. However, both states still have thriving black markets for THC products. For example, “[a]s much as 80% of the marijuana sold in California comes from the black market.” In April 2019, Oregon police seized an estimated $15 million in black market marijuana products.

Overwhelmingly, a notorious black-market THC product (that is completely illegal) is being linked to recent vaping-related hospitalizations. A September 6 report in The New England Journal of Medicine examined vaping-related hospitalizations in Illinois and Wisconsin. In these cases, 21 of 41 patients reported “using a THC product … marketed under the ‘Dank Vape’ label.” Additionally, 38 percent of self-reporting patients in Utah used Dank Vapes prior to their lung illnesses. Dank Vapes is an illegal, unlicensed product. Essentially, Dank Vapes is a shady packaging company and has been implicated for putting a Wisconsin man into a coma.

Despite these findings, many states are moving to restrict access to tobacco harm reduction products that are regulated and have yet to be definitively linked to any adverse health effects. Since their introduction to the U.S. market in 2007, e-cigarettes have helped an estimated three million American adults quit smoking combustible cigarettes.

Further, e-cigarettes and vaping devices are much less harmful than combustible cigarettes. Numerous public health groups including Public Health England, the Royal College of Physicians, and the National Academies of Sciences, Engineering and Medicine have all noted e-cigarettes’ reduced harm potential. Further, in June 2019, the American Cancer Society declared e-cigarettes to be “significantly less harmful for adults than smoking regular cigarettes […] because e-cigarettes do not contain or burn tobacco.”

Lawmakers need to understand that health departments and the CDC have linked the vast majority of recent vaping-related lung illnesses to THC devices. Moreover, most of these products are illegal and unregulated. Restricting sales of regulated nicotine-containing e-cigarettes will not reduce recent vaping-related hospitalizations and will likely lead to more black-market activity.

The following documents provide more information on e-cigarettes and tobacco harm reduction.

Tobacco Harm Reduction 101: A Guidebook for Policymakers
https://www.heartland.org/publications-resources/publications/latest-heartland-policy-booklet-addresses-vaping-myths
This booklet from The Heartland Institute aims to inform key stakeholders on the much-needed information on the benefits of electronic cigarettes and vaping devices. Tobacco Harm Reduction 101 details the history of e-cigarettes, including regulatory actions on these products. The booklet also explains the role of nicotine, addresses tax policy and debunks many of the myths associated with e-cigarettes, including assertions about “popcorn lung,” formaldehyde, and the so-called youth vaping epidemic.

Podcast Series: Voices of Vapers
https://www.heartland.org/multimedia/podcasts?fromDate=&toDate=&q=voices+of+vapers
In this weekly podcast series, State Government Relations Manager Lindsey Stroud talks with researchers, advocates, and policymakers about tobacco harm reduction and electronic cigarettes. The series provides important information about the thousands of entrepreneurs who have started small businesses thanks to THRs and the millions of adults that have used electronic cigarettes and vaping devices to quit smoking tobacco cigarettes.

Vaping, E-Cigarettes, and Public Policy Toward Alternatives to Smoking
https://www.heartland.org/publications-resources/publications/vaping-e-cigarettes-and-public-policy-toward-alternatives-to-smoking
For decades, lawmakers and regulators have used taxes, bans, and burdensome regulations as part of their attempt to reduce the negative health effects of smoking. Recently, some have sought to extend those policies to electronic cigarettes. This booklet from The Heartland Institute urges policymakers to re-think that tax-and-regulate strategy. Policymakers should be mindful of the extensive research that supports tobacco harm reduction and understand bans, excessive regulations, and high taxes on e-cigarettes often encourage smokers to continue using more-harmful traditional cigarette products.

Policy Tip Sheet: Vaping Hospitalizations Likely Linked to Black Markets
https://www.heartland.org/publications-resources/publications/policy-tip-sheet-vaping-hospitalizations-likely-linked-to-black-markets
In this Policy Tip Sheet, State Government Relations Manager Lindsey Stroud examines recent headlines, finding vaping-related hospitalizations are likely linked to illegal black market vaping products. Stroud examines reports from January 2019 which found youth were being hospitalized due to marijuana vaping products. Further, in 2018, the U.S. Army warned of the dangers of vaping synthetic marijuana after more than 90 military personnel were hospitalized and two died after vaping such devices. Further, none of the reports on the recent hospitalizations have been able to identify a single product that would have caused adverse health effects.

Policy Tip Sheet: E-Cigarettes Are Safer than Combustible Cigarettes
https://www.heartland.org/publications-resources/publications/policy-tip-sheet-e-cigarettes-are-safer-than-combustible-cigarettes
In this Policy Tip Sheet, Lindsey Stroud, a state government relations manager at The Heartland Institute, rebuts claims that electronic cigarettes and vaping devices are just as harmful as combustible cigarettes. Stroud points to the numerous public health groups that have found e-cigarettes to be significantly less harmful, with at least two public health organizations claiming their use to be at least 95 percent safer than combustible cigarettes. E-cigarettes reduced harm is due to these products not containing tobacco and that they do not use combustion, or burn tobacco, which is believed to cause the most harm with tobacco cigarette use.

Popcorn Lung, Formaldehyde, and Now Seizures, Oh My!
https://townhall.com/columnists/lindseystroud/2019/04/19/popcorn-lung-formaldehyde-and-now-seizures-oh-my-n2545054
In this opinion piece in Townhall, Lindsey Stroud, state government relations manager at The Heartland Institute, responds to exaggerated and false claims of e-cigarettes. Despite fearmongering news stories, myths surrounding e-cigarettes containing formaldehyde and creating popcorn lung are unfounded, and the risk of seizures is minute. Stroud urges lawmakers to refrain from enacting egregious legislation in response to these claims.

Research & Commentary: Qualitative Study on E-cigarettes Shows More Evidence of Tobacco Harm Reduction
https://www.heartland.org/publications-resources/publications/qualitative-study-on-e-cigarettes-shows-more-evidence-of-tobacco-harm-reduction?source=policybot
In this Research & Commentary, Heartland Institute State Government Relations Manager Lindsey Stroud examines a study, published in The International Journal of Environmental Research and Public Health in June 2016, that provides additional evidence showing e-cigarettes and vaporized nicotine products (VNP) are an effective tobacco harm-reduction tool.

Nothing in this Research & Commentary is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute. For further information on this and other topics, visit the Budget & Tax News website, The Heartland Institute’s website, our Consumer Freedom Lounge, and PolicyBot, Heartland’s free online research database.

The Heartland Institute can send an expert to your state to testify or brief your caucus; host an event in your state; or send you further information on a topic. Please don’t hesitate to contact us if we can be of assistance! If you have any questions or comments, contact Heartland’s government relations department, at governmentrelations@heartland.org or 312/377-4000.