Once upon a time — mere months ago, actually — vapes and e-cigarettes were framed as a healthier (or at least more responsible) alternative to cigarettes. Now, a series of mysterious and possibly vape-induced illnesses and sudden deaths have stirred up enough chaos and fear to get even the president's attention. Is it still safe to vape? It depends on what you're vaping, and on your tolerance for risk.
Because there just isn't that much medical research on vaping's health effects — the technology is simply too new — concerns over the recent cases of sudden strange lung disease have colored the larger debate over vaping's potential long-term health problems versus its potential for harm reduction by keeping people from smoking cigarettes.
But when it comes to the mysterious vape-illness "epidemic," public health officials have at least isolated a factor you can avoid: weed-infused vaping cartridges.
Mysterious vape illness: tell me more about that
Locally, at least 10 people have developed a strange lung disease associated with vaping. Across the country, six people so far have died from a mysterious, sudden-onset respiratory illness. The unifying theme in the deaths, and in the hundreds of other non-fatal cases (about 450, at time of writing) that have cropped up, has been vape use — specifically, the use of THC- or cannabinoid-infused vape liquid.
An investigation by the U.S. Food and Drug Administration, as well as an analysis conducted by the New York State Department of Health, pinpointed Vitamin E acetate as a probable offender. Taken as a supplement or applied in creams, vitamin E is harmless, but when inhaled as an oil — as a thickening agent in "vape juice," for example — it may cause lipoid pneumonia, the disease that landed a number of recent vaping casualties in the hospital. Investigators found vitamin E acetate in almost all of the cannabis samples submitted by sick New Yorkers in recent weeks.
Vitamin E oil appears to be an additive: The FDA did not find it in the nicotine vape juice it tested, meaning the standard-issue Juul pod you bought direct from the manufacturer shouldn't have it.
But the FDA also hasn't come up with a bulletproof explanation yet: "No one substance, including vitamin E acetate, has been identified in all of the samples tested," a spokesperson told NBC News. "Importantly, identifying any compounds that are present in the samples will be one piece of the puzzle but will not necessarily answer questions about causality."
So my Juul is safe?
With respect to the recent rash of pulmonary illnesses alone, probably, provided you're not swapping in weed pods or other bootleg cartridges for your regular nicotine ones.
But the more complete answer is: we don't know how risky Juuling is.Commercial e-cigarettes have really only been around for about 15 years, making the technology a little too young for us to fully grasp the eventual implications of regular Juul use. Nonetheless, the American Lung Association heavily suspects vaping, which is just the deep inhalation of chemicals, could definitely translate to lung and cardiovascular disease, just like regular smoking does. Researchers have also flagged a common flavoring chemical, diacetyl, for its association with "popcorn lung," a form of bronchitis. Flavoring agents may also impair cilia function in the airways, potentially leading vapers to develop lung diseases like COPD and asthma down the line. Again, we don't really have the longterm data to know for sure.
That uncertainty prompted the FDA to slap Juul with a stern warning earlier this week: Either clarify to consumers, via your advertising, that you can't guarantee vaping is actually safer than smoking cigarettes, or we will start fining you and maybe even seizing your product.
Is that why people keep talking about flavored e-cigs being so dangerous? Because they contain additives?
In part, yes. The supersweet flavors — your fruit, creme, and mango Juul pods; your blueberry muffin and strawberry milkshake pods from lesser-known manufacturers — are catnip for teens and tweens, who vape at truly astounding rates. According to a February 2019 survey of 44,000 U.S. students conducted by the National Institutes of Health, 37 percent of 12th graders vaped in 2018, nearly a 10 percent increase from the previous year. Meanwhile, over 32 percent of 10th graders and nearly 18 percent of eight graders admitted to vaping.
Juul has always maintained that its product exists to help smokers quit, and the company's CEO Kevin Burns recently advised all potential customers who don't have a "preexisting relationship with nicotine" not to vape at all. But Juul, the leader in vape brand recognition, appears to have targeted teens directly: The House Oversight and Reform Committee recently launched a probe into the company's dealings, and found that Juul dumped hundreds of thousands of dollars into youth programs, and even sent ambassadors into high schools. At the hearings, co-founder James Monsees insisted that he "could not be more concerned" about the teen vaping trend, while Chief Administrative Officer Ashley Gould argued that the purpose of those "short-lived" youth programs, intended "to educate youth on the dangers of nicotine addiction," had been "misconstrued." Juul's goal had been to "keep youth from using the product," Gould said. Still, skepticism persists, because while a reformed (or reforming) adult smoker might understandably replace cigarettes with pod flavors like Virginia Tobacco and Menthol, the switch to tutti fruiti makes...less sense.
Is vaping still legal in New York?
For now, yes. Last week, Michigan became the first state in the country to temporarily ban the sale of flavored e-cigarettes, but so far, cheese stands alone on that one. A bill currently before City Council has similarly proposed banning the sale of flavored e-cigs (even mint!) in NYC.
At a state level, Governor Andrew Cuomo — a self-described "cool dude in a loose mood" — has recommended banning flavored e-cigs in an effort to scale back the numbers on teen vaping, and to rein in the current public health hazard. He also ordered the state health department to subpoena three companies that have supposedly been selling suspicious thickening agents. "Common sense says if you don’t know what you’re smoking, don’t smoke it,” he said at a Monday press conference. “And right now, we don’t know what you’re smoking in a lot of these vaping substances." As of Monday, 41 New Yorkers had come down with the apparent vaping disease.
Meanwhile, NY Assemblywoman Linda Rosenthal reportedly plans to introduce a bill outlawing all e-cigs until the FDA approves them, and on Tuesday, former NYC mayor Michael Bloomberg announced he was throwing $160 million behind a multi-city-and-state effort to ban flavored vape juice. For now, New York State Health Commissioner Howard Zucker recommends that everybody just put down their vapes, both legal and not, until the experts have a better idea about what's causing all this illness.
So should I feed my Juul to the sea, y/n?
Listen, you are the captain of your own ship! I can't tell you what to do. If you are not presently addicted to nicotine, it seems prudent to me — a blogger who is absolutely not a health expert — to abadon your Juul, and/or find another way to put cannabis in your body, if that's what you're after.
If you are addicted to nicotine, currently available evidence suggests that your untampered-with Juul pod is less likely (compared to that black market, or even dispensary, weed pod you bought) to give you the mysterious lung disease that's sending people to the hospital right now — but who knows what it might do to your body over time.
