I’m saddened by the recent tragic events surrounding the illness and deaths associated with vaping.   My deepest sympathy goes out to all who are directly affected, and I send my best wishes for complete and speedy recovery to those who are working hard to overcome the adverse health effects they’ve encountered.  May we all, collectively, recognize the current tragedy as a reminder that unscrupulous folks, anxious to make a buck, will place the health and well-being of the masses considerably lower on the ethical totem pole than they place their dollar signs.  Let this be a call to action for everyone who wants to be able to trust that the products we consume are safe.  And finally, may all who knowingly evade the public into purchasing and using sub-standard products for the sake of the Almighty Dollar wake up to the harm they are inflicting and change their ways.

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One of the beautiful qualities of aging is the wealth of memories we older ones can draw from the depths of our archives.  We don’t necessarily remember things the way they actually were, or the way others do, which, again, is a beautiful thing, as our personal archived recollections hold onto the emotions we were experiencing and the cultural priorities of the times.  For example, I have pretty clear early childhood memories of “The Marlboro Man,” a rugged, manly, testosterone-dripping hunk of a cowboy who rode a big, beautiful stallion and brazenly sold Marlboro cigarettes — up until the publication of the U.S. Surgeon General’s 1964 report on Smoking and Health, when the tides began to change.  Until that time, cigarette commercials on television and within the glossy pages of magazines portrayed smoking as smooth, savvy, sexy – all things good.  Mainstream media and public officials routinely supported the false claims being generated by the tobacco industry — to the extent that smoking cigarettes was actually considered healthy.  Man, have the times changed!

Or have they?

Fast-forward 50 years or so, and the nicotine capitalists are again playing a sick version of roulette with the lives of us common folks, this time claiming that puffing on highly addictive e-cigarettes is somehow safer than smoking. And until now, they’ve gotten a free pass from industry-friendly regulators who appear to be complicit in a new and improved way to b.s. the public. Highly effective advertising aimed at teens (yes, at our children!) as well as adults, vape-product ads have been commending the virtues of vaping on national television, including at the very moment the Center for Disease Control (CDC) issued an alarming report associating a sudden outbreak of deaths and pulmonary disease to harmful vaping products.  More than 500 people, including teenagers and seniors, have been hospitalized with health problems ranging from shortness of breath to severe nausea and coughing up blood. So far, nine deaths have been directly attributed to vaping. Of those who have been stricken by vaping-related lung disease, some had been using only nicotine e-cigarettes, but most cases involve people who vaped inferior-quality, unlicensed cannabis oil products.  The CDC has not been able to conclusively link a single product or substance to vaping disease. According to the CDC, the likely cause is “unknown chemical exposure.”

That’s a hard one to swallow, considering that the chemicals in the vape pen are known, and not necessarily known to be safe.  Thinning agents such as propylene glycol (PG) and polyethylene glycol (PEG), plus a wide spectrum of flavoring additives, have received the stamp of approval from the FDA – but the approval is based on data related to oral consumption of ingestible compounds (eating).  There is little, if any, evidence supporting the idea that FDA-authorized texturing and flavoring agents are safe when heated and inhaled. Any thinning agent or flavor-enhancing chemical that has not been safety-tested for heat and inhalation exposure should be prohibited as additives to CBD oil. Additionally, some black-market vape-oil products are spiked with potent synthetic intoxicants erroneously described as “synthetic marijuana” – and with plenty of other dubious compounds. Tobacco smoke and cannabis smoke both contain noxious polyaromatic hydrocarbons and carbon monoxide, but the negative effects of cannabis smoke are significantly mitigated by the cytoprotective and antitumoral properties of cannabis components. Inhaling additive-free, artisanal whole plant cannabis oil with a well-made vaping device is just as safe, if not more so, than smoking organically grown cannabis.

CBD consumers frequently assume that vaping cannabis or hemp oil is healthier than inhaling smoke, which contains toxic substances that can irritate the lungs. Theoretically, a vaporizer heats the cannabis oil concentrate without burning it, so the active ingredients are inhaled but no smoke is involved.  However, there may be a serious downside to vaping CBD oil and other cannabis oil extracts. We all learned in high-school chemistry class that combustion can change a compound into something much more dangerous than the original, which is the case with e-cigarette additives that the FDA has deemed safe for ingestion. But smoking/vaping these additives? Not so much. Vape pens contain battery-operated heating mechanisms, which, at high temperatures, can transform solvents, thinning agents, and flavor additives into carcinogens and other dangerous toxins. A 2018 study by University of Rochester scientists found that exposure to commonly used e-cigarette flavoring chemicals and liquids is toxic to white blood cells. Furthermore, many flavoring compounds are toxic when heated and inhaled; cinnamon, vanilla, and cream flavors are not only the most popular, they are among the most toxic. A recent report by Yale University researchers showed that mixing chemical flavoring agents is even more dangerous than exposure to a single additive. Moreover, some flavor additives interact with PG and PEG to form toxic acetal compounds. When heated and inhaled, these inflammatory chemicals remain in the body for extended periods and irritate the lungs.  A specific chemical, diacetyl, is added to e-cigarettes and vape oil cartridges to simulate various buttery flavors, ranging from cream to vanilla and caramel. This particular compound is known to cause “popcorn lung,” a crippling and sometimes fatal respiratory illness. A shocking 2015 study of flavored e-cigarettes found that 39 out of 51 of the tested brands contained diacetyl.

As mentioned above, many vape oil cartridges include propylene glycol (PG) or polyethylene glycol (PEG) as thinning agents, but neither has been safety-tested by the FDA for inhalation when heated. Because of low oral toxicity, PG is classified by the FDA “generally recognized as safe” — again, for ingestion as a food additive. PG is also the primary ingredient in a majority of nicotine-infused e-cigarette solutions. At high temperatures, PG and other vaping additives convert into carbonyls, a group of cancer-causing chemicals that includes formaldehyde.  What?!?

The FDA is a big part of the vaping problem. Consumers who vape cannabis oil products should not be exposed to harmful compounds. Responsible CBD companies have urged the FDA and state officials to prohibit the use of any thinning agent or flavor-enhancing additive that has not been safety-tested for heat and inhalation exposure. A similar standard should apply to additives in nicotine e-cigarettes. State health officials should not take their cues from the FDA when it comes to regulating vape oil additives. One responsible CBD company, in public comments submitted to the FDA, stated: “The precautionary principle mandates that any thinning agent or flavor-enhancing chemical that has not been safety tested for heat and inhalation exposure should be prohibited as a cannabis oil additive.”  Hmmmm. . . seems like a no-brainer to me.

Vapes are everywhere, and they’re incredibly easy to access, even for underage teens. CBD vapes can easily be purchased at grocery stores, convenience stores, gas stations, on the internet, and from an entire variety of less-than-savory sources.  However, responsible CBD companies have been warning about the potential dangers of toxic vape oil additives, particularly thinning agents and flavoring additives, since 2015, a full year before e-cigarettes came under the FDA’s regulatory purview.

Interestingly, different groups have been trying to spin the vaping tragedy to advance their own agendas. Prohibitionists are calling for a total ban on vaping cannabis. Trade industry groups, who were radio-silent on the dangers of vape oil additives before the scandal surfaced, are now professing concern about the health risks of illicit vaping options. And we can always blame China for exporting cheap vape pens with erratic heating coils that turn seemingly benign compounds into carcinogens and cause tainted oil to smolder.  It’s enough to make anyone’s head spin, and to confuse everybody.

The solution isn’t to ban cannabis vaping across the board. Such a misguided policy would be both impractical and counterproductive, boosting black-market commerce and increasing risks for users. Rather than banning an entire product category, state health officials should implement a rigorous regulatory program that prioritizes public health and raises the safety standards.

Sources:

https://www.sciencedaily.com/releases/2018/01/180130123244.htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018193/

https://www.lung.org/about-us/blog/2016/07/popcorn-lung-risk-ecigs.html