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Vaping and lung illnesses: What is behind this curious US phenomenon?

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There has now been more than 450 cases of serious lung illnesses linked to vaping in the US.

The American media, public health bodies and anti-tobacco NGOs have been out in force warning people of the supposed threat of e-cigarettes.

However, it’s become increasingly apparent that THC oil – not commercially-available nicotine e-liquid – is the likely culprit.

Some scientists believe that we may be seeing a new type of lipoid pneumonia that could be linked to vitamin E acetate found in home-made THC oils.

A study published in the New England Journal of Medicine on Friday found that of 53 case studies across Wisconsin and Illinois, 84 percent of patients reported using a THC product.

It’s perhaps important to note that recreational cannabis is illegal in both of these states so the real figure could be even higher.

Daniel Fox, a pulmonary specialist from WakeMed working on the research, said:

“All of our patients underwent evaluation, and after the clinical evaluation we found a certain type of pneumonia that was noninfectious.

“It’s called lipoid pneumonia. Basically, it can occur when either oils or lipid-containing substances enter the lungs”

Dangerous synthetic drugs structurally similar to THC have also been widely available in the US since around 2008.

Since issuing its first warning in August, the Centers for Disease Control and Prevention (CDC) has continued to conflate nicotine e-cigarettes with often black-market THC products.

This has played out in the media, with countless headlines warning of the dangers of ‘vaping’ and ‘e-cigarettes’ while the ensuing news stories acknowledge that THC oil, not nicotine PG/VG e-liquid, is found in a large proportion of the cases.

There’s a lot of debate around what might explain the CDC’s actions but it would be irresponsible of us to speculate without evidence.

However, a Twitter discussion between CNBC health correspondent Angelica LaVito and former FDA commissioner Scott Gottlieb may have shed some light.

While the UK media has unfortunately followed America’s lead with sensationalist headlines, a Guardian article published on Saturday offered some balance and allayed the fears of British vapers.

Public health experts including Martin Dockrell of Public Health England and Deborah Arnott of ASH noted that there have been no reported cases serious side-effects from e-cigarette-use in the UK, where e-liquids are tightly regulated by the MHRA.

Prof Linda Bauld, a public health expert at Edinburgh University, said:

“It seems highly unlikely that widely available nicotine-containing vaping products, particularly of the type regulated in Europe, are causing these cases.

“All the evidence to date suggests that illicit marijuana vaping products (THC oils) are the cause. In particular, a compound called tocopherol acetate may be the culprit”

Of course, if 99 percent of the cases can be blamed on THC oils, that means that nicotine e-liquids could potentially be blamed for one percent, which is still too many.

However, even if some of the cases can be attributed to e-cigarette products ‘acquired from unknown or unauthorized (i.e., “street”) sources’, as the initial CDC alert suggested, this is surely a red flag of what could happen if flavour bans and excessive regulation push vaping underground and force an e-cigarette black-market to flourish.

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