Vaping Lung Illness: What You Need to Know

Starting in the summer of 2019, a lung disease relating to vaping began to sweep across the United States, eventually sickening more than 2,500 people and killing dozens. The disease doesn’t have a concrete medical name yet, but two have been suggested:

  • Vaping-Associated Pulmonary Injury (VAPI)
  • E-Cigarette or Vaping Product Use Associated Lung Injury (EVALI)

The medical community seems to have gravitated toward the first name, so we’ll use the term VAPI to refer to the disease for the remainder of this article. VAPI is perhaps the biggest controversy ever to hit the vaping community, and the controversy arose largely due to confusion regarding its root cause.

At first, medical experts advised people to stay away from all vaping products related to THC, CBD and vape juice. Somehow, though, the recommendation rang a bit hollow. The American e-liquid industry, after all, had been regulated by the FDA since 2016. Since that time, vape juice makers have been unable to change their ingredients without first submitting applications to the FDA – something no company has ever done. How could a product left essentially unchanged for three years suddenly cause an outbreak of a terrible disease? There had to be another reason.

The cause of VAPI appears to be vaping products based on THC oil, purchased primarily from unregulated sources.

If you’re a cannabis vaper, this article is for you. We’re going to explain what’s happening, why VAPI is a recent occurrence and what you can do to continue using cannabis safely.

VAPI is a form of lipoid pneumonia in which oil settles in the lungs and prevents the absorption of oxygen from the air. The body senses damage to the lungs and engages the immune system, which attacks the oil deposits as if they were pathogens. However, VAPI is not caused by an infection.

People who contract VAPI experience symptoms such as chest pain, shortness of breath, insufficient oxygen supply, coughing, diarrhea, vomiting and fever. Some people have experienced lung failure and have required mechanical ventilation. Dozens of people have died, but doctors have reported that many people have improved with the systemic administration of corticosteroids.

Some VAPI patients have experienced relapses upon being released from hospital treatment. The long-term prognosis for VAPI patients is unknown; it’s possible that the disease causes permanent lung damage.

What Is the Cause of VAPI?

Researchers haven’t isolated an individual ingredient or product common among all VAPI patients. This, however, is a summary of the findings to date:

  • Most VAPI patients have stated that they used THC products prior to the onset of illness.
  • Some VAPI patients have stated that they used nicotine vaping products and did not use THC products. However, research has been complicated by the fact that many of those patients were found to be lying about their THC use.
  • Thousands of vaping product samples have been submitted by VAPI victims for analysis. Most of those samples were illegal THC oil vaping cartridges produced privately for black-market distribution.
  • The most likely cause of VAPI appears to be Vitamin E acetate. Vitamin E has been found in lung fluid samples taken from almost all VAPI victims.

In short, the leading cause of VAPI appears to be illegal THC oil vaping cartridges that contain Vitamin E acetate.

Why Is Vitamin E in THC Vaping Cartridges?

Vitamin E is in THC vaping cartridges because it’s a way to dilute THC oil and make the cartridges appear more potent than they are. Buying a THC cart isn’t like buying whole flowers; there’s nothing for you to inspect apart from a clear cartridge filled with a golden liquid. Without a lab test, you have no idea what you’re buying.

THC Oil Dilution for the Legitimate Cannabis Industry

Pure THC oil is extremely thick and tends not to work well in a small vaping cartridge. Therefore, it’s necessary to dilute the oil until it has the necessary consistency to flow through a ceramic wick. Licensed producers of legitimate cannabis products typically dilute the THC oil with plant-derived terpenes. Cannabis is a rich source of terpenes anyway, and enriching THC oil with additional terpenes gives the oil a pleasant flavor. Terpenes, however, are expensive. Legitimate cannabis businesses will use terpenes, but unlicensed sellers will not.

THC Dilution for the Illegal Cannabis Industry

Propylene glycol and vegetable glycerin – the two most plentiful ingredients in nicotine e-liquid – are inexpensive and can also be used to dilute THC oil. The problem with those ingredients, however, is that it’s obvious when they’re being used because the resulting oil becomes very thin. The THC vaping community invented the “bubble test” to identify phony THC cartridges. If you invert a heavily diluted THC cartridge – and the air bubble moves quickly to the other side of the cartridge – the cartridge is fake.

In any THC cartridge, the THC oil is the most expensive ingredient – and people in the THC dealing business will seize any possible opportunity to use less THC oil in their cartridges while charging the same amount of money for those cartridges. Therefore, heavy dilution of THC cartridges isn’t really a problem of the legitimate cannabis industry; it’s a problem of the black-market industry.

In 2019, unlicensed producers of THC vaping cartridges discovered that Vitamin E acetate has virtually the same color and consistency as THC oil. It’s possible, in fact, to fill more than half of a cartridge with Vitamin E and top it off with THC oil – and no one can tell the difference from a visual inspection. VAPI appeared shortly after Vitamin E-based cutting agents became ubiquitous in illegal THC cartridges.

How Can I Vape Cannabis Safely?

Reading this article, you’ve learned that producers of THC vaping cartridges have a strong financial incentive to use as little THC oil as possible in their cartridges, so they can earn the most money possible. At this point, everyone knows that Vitamin E acetate is dangerous to inhale, but the people producing illegal THC cartridges are anonymous and aren’t particularly concerned about users’ safety. If you buy a THC cartridge on the street, you know nothing about what’s in the cartridge and are taking a terrible risk. If you buy cannabis privately, you should never buy anything but whole flowers.

Even if you buy from a licensed dispensary, it’s still wise to avoid all liquid THC vaping products for the foreseeable future. In 2019 and 2020, thousands of dispensary-stocked vaping products were recalled in Michigan because Vitamin E was detected in those products. If you decide to buy THC cartridges from your local dispensary anyway, make sure that those cartridges have been tested for Vitamin E by a third-party laboratory.



Shane Dwyer
Author: Shane Dwyer
Shane Dwyer is a cannabis advocate who isn't afraid to tell the world about it! You can find his views, rants, and tips published regularly at The 420 Times.

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