The Centers for Disease Control and Prevention confirmed on Friday that the additive vitamin E acetate is the likely cause of the nation’s rash of lung injuries caused by vaping. Dr. Anne Schuchat, the principal deputy director of the CDC, told reporters that the additive, which received early attention as a potential cause of e-cigarette or vaping product use–associated lung injury (EVALI), was found in the lung tissue of patients by investigators.
“For the first time, we have detected a potential toxin of concern: vitamin E acetate,” Schuchat said. The CDC referred to the discovery as a “breakthrough.”
The investigators had tested fluid samples in a study of 29 EVALI patients from 10 states and had found vitamin E acetate in all 29 cases. No other oils, including plant oils or mineral oil, were found in the samples.
“These findings provide direct evidence of vitamin E acetate at the primary site of injury within the lung,” Schuchat added.
Vitamin E acetate is a synthetic form of the nutrient that is commonly used in nutritional supplements, foods, and personal care products. When taken orally or applied topically, it is generally considered safe. When inhaled, however, vitamin E acetate can coat the lungs, causing difficulty breathing and other serious health effects.
Unlicensed THC Products Under Scrutiny
In September, the New York Department of Health announced that it had discovered vitamin E acetate in nearly all of the cannabis vape cartridges associated with the vaping illnesses. On Friday, the Cannabis Trade Federation urged legal cannabis businesses to avoid the additive.
“While it still appears these health incidents are primarily associated with the use of illicit THC vape products, we urge members of the regulated cannabis industry to be vigilant and review all of their vaping products to ensure they are free of vitamin E acetate,” the statement reads.
The industry group also urged officials in states that have regulated cannabis for medical or recreational use to ensure that vitamin E acetate is clearly prohibited by state regulations from being used in any cannabis products meant to be inhaled.
“This health crisis and the recent breakthrough in the investigation underscore the importance of existing state cannabis regulations, as well as the need for strict cannabis regulation at both the state and federal levels,” added the CTF.
Also on Friday, the CDC revealed in a separate report that the Illinois Department of Health had found that a majority of the EVALI patients in that state had said that they had used THC cartridges that had been purchased on the street or from friends rather than from licensed dispensaries.
Health officials also compared patient data with the responses of 4,000 individuals who said they vaped but had not become ill. Among them, 94% said that they had only vaped nicotine products.
Dr. Jennifer Layden, the chief medical officer for Illinois said that those who were sick were “roughly nine times more likely to obtain the THC-containing products from informal sources, such as a dealer, off the street or from a friend, compared to survey respondents.”
Patients treated for EVALI were also eight times more likely than healthy respondents to report using the THC cartridges sold under the counterfeit brand Dank Vapes.
Although the CDC says it has confirmed that vitamin E acetate is causing at least some cases of the mysterious lung illnesses, they can not rule out the possibility of other causes. As of Thursday, the federal agency says that there have been 2,051 cases of EVALI. Of those, 39 patients have died.