Decades Versus Days | The U.S. Vape Crisis
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What Is Known:
As of December 10th, 2019, the US Center for Disease Control has confirmed reports of 52 deaths, and a 2,409 patients have been hospitalized with EVALI from all 50 states, the District of Columbia, Puerto Rico, and the Virgin Islands.
What Is New
CDC has analyzed national data on the use of THC-containing product brands by e-cigarette, or vaping, product use-associated lung injury (EVALI) patients.
- Overall, 152 different THC-containing product brands were reported by EVALI patients.
- Dank Vapes, a class of largely counterfeit THC-containing products of unknown origin, was the most commonly reported product brand used by patients nationwide, although there are regional differences. While Dank Vapes was most commonly reported in the Northeast and South, TKO and Smart Cart brands were more commonly reported by patients in the West and Rove was more common in the Midwest.
- The data further support that EVALI is associated with THC-containing products and that it is not likely associated with a single THC-containing product brand.
CDC and FDA recommend that people should not use THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online sellers.
Vitamin E acetate should not be added to e-cigarette, or vaping, products. Additionally, people should not add any other substances not intended by the manufacturer to products, including products purchased through retail establishments.
CDC, FDA, and state health authorities have made progress in identifying substances of concern in EVALI. However, there are many different substances and product sources that remain under investigation, and there may be more than one cause.
The latest national and state data from patient reports and product sample testing suggest THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online dealers, are linked to most of the cases and play a major role in the outbreak.
While it appears that vitamin E acetate is associated with EVALI, there are many different substances and product sources that are being investigated, and there may be more than one cause.
Therefore, the best way for people to ensure that they are not at risk while the investigation continues is to consider refraining from the use of all e-cigarette, or vaping, products.
What Is Not Known:
While it appears that vitamin E acetate is associated with EVALI, there are many different substances and product sources that are being investigated, and there may be more than one cause.
At this time, FDA and CDC have not identified the cause or causes of the lung injuries in these cases, and the only commonality among all cases is that patients report the use of vaping products. This outbreak might have more than one cause, and many different substances and product sources are still under investigation. The specific chemical exposure(s) causing lung injuries associated with e-cigarette product use, or vaping, remains unknown at this time. Even though no cause has been identified, most patients report a history of using cannabis containing products. The latest national and state findings suggest products containing THC, particularly those obtained off the street or from other informal sources (e.g. friends, family members, illicit dealers), are linked to most of the cases and play a major role in the outbreak.
What Needs To Happen:
No matter the root cause of this vape crisis, it is critical that the legal cannabis industry demonstrates their commitment to resolving the issue by being proactive, transparent, and accountable in all communications. Education, authenticity, and candor are vital to repairing and rebuilding public trust. The cannabis industry must publicly demonstrate the steps being taken steps to prevent these issues from happening again and share the policies that will be put into place as assurance.
What Should Be Done Now:
In an effort to assist, FOCUS has developed resources for industry and consumers that are available for download and sharing. The industry resource contains suggested actions that cannabis industry operators can implement immediately to minimize further damage and begin to rebuild trust. The consumer resource contains suggested actions consumers can take to protect themselves. These suggestions are in no way exhaustive. Nor is this information intended as a resolution to this tragic crisis. A real resolution will take time, research, and the implementation of comprehensive cannabis standards across all sectors of the industry. FOCUS is here to help.
FOCUS Resources
- FOCUS Industry Guidance (Downloadable PDF)
- FOCUS Patient Guidance (Downloadable PDF)
- FOCUS Days Verses Decades (Downloadable PDF)
- Check Out Our Recent Webcast On The Vape Crisis
Publications On Vape Crisis
- MMWR: E-cigarette Use, or Vaping, Practices and Characteristics Among Persons with Associated Lung Injury — Utah, April–October 2019
- MMWR: Update: Interim Guidance for Health Care Providers Evaluating and Caring for Patients with Suspected E-cigarette, or Vaping, Product Use Associated Lung Injury — United States, October 2019
- MMWR: Characteristics of a Multistate Outbreak of Lung Injury Associated with E-cigarette Use, or Vaping — United States, 2019
- MMWR: E-cigarette Product Use or Vaping Among Persons with Associated Lung Injury — Illinois and Wisconsin, April–September 2019
- MMWR: Severe Pulmonary Disease Associated with Electronic-Cigarette–Product Use — Interim Guidance
- MMWR: Notes from the Field: Outbreak of Electronic-Cigarette Associated Acute Lipoid Pneumonia—North Carolina, July–August, 2019
- New England Journal of Medicine: Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin — Preliminary Reportexternal icon