
Vaping Illnesses Are Linked to Vitamin E Acetate, CDC Says - mhb
https://www.nytimes.com/2019/11/08/health/vaping-illness-cdc.html
======
yborg
When this story first came out several months ago, an HN commenter in the vape
liquid business fingered this as a possible source of the problem. Can't find
the comment now, but always impressed by the nuggets of real information that
crop up on HN.

~~~
_Marak_
May have been me
[https://news.ycombinator.com/item?id=20905712](https://news.ycombinator.com/item?id=20905712)
, but I'm not in the vape liquid business.

~~~
raihansaputra
There was another comment, and the poster was talking about cutting the THC
concentrate with Vitamin E oils which is dangerous to vaporize and inhale. I
can't find it too though.

------
resfirestar
As much as I support states refusing to wait for the feds to end our
disastrous war on drugs policy, this is a reminder that unless we legalize and
regulate marijuana at the federal level and make serious efforts to make the
legal market work for _everyone_ , there will continue to be a black market.
That black market will continue to land people in jail (disproportionately
black, Latino, and economically disadvantaged people), help to prop up drug
traffickers, and even, as appears to have happened here, needlessly sicken and
kill the consumers in an effort to meet demand for products popularized in
legal markets. I worry that the marijuana business will be content with
descheduling and stop pressing for action as soon as they can use the
financial system, and our political system, through inertia, will leave
everything else to an ineffective patchwork of state laws.

Edit: Just on the subject of ongoing concerns over vaping and health, another
critical thing legalization would allow is research. While this particular
health crisis for now looks to be mostly or entirely caused by vitamin E oil,
there is a lack of science on the long term effects of vaping weed in oil or
flower form. There isn’t even that much research on smoking due to the
prohibition, and the evidence we do have, which indicates that smoking weed
has similar carcinogenic effects to tobacco, isn’t widely known.

~~~
cmdshiftf4
>As much as I support states refusing to wait for the feds to end our
disastrous war on drugs policy, this is a reminder that unless we legalize and
regulate marijuana at the federal level and make serious efforts to make the
legal market work for everyone, there will continue to be a black market

Canada legalized and regulated marijuana at the federal level over a year ago
and yet 40% of users still prefer to get it from the black market.

Vaping weed became very popular here also and there's no official source for
THC vape cartridges.

>That black market will continue to land people in jail

Yes, breaking laws may result in incarceration. Even if you legalize it and
regulate it, there will still be many people who'll roll the dice and try to
undercut the market for their own gain.

~~~
raydev
Based on what I've heard from others (I don't smoke), the black market in
Canada still exists because of poor quality relative to cost, and low supply.
Supposedly.

Also, the black market is probably running off inertia due to existing supply,
and how easy it is to grow plants as an individual. I don't think anyone
expected the black market to disappear overnight. It's only been a year.

------
dmix
This would be a good time to check old HN and Reddit threads for all of the
hysteria and “we told you” stuff being spread after this originally hit the
news. I also noticed a bunch of health agencies took advantage of the
headlines to stir up fear around using them, they never specified what types
to watch out for.

I was immediately suspicious that after a decade (or longer) of vaping being
popular that all of a sudden people started dying out of nowhere. If it was
caused by standard e-cigarettes it there would have been a gradual increase in
cases.

The early warning signs that it was strictly a small subset of shady black
market THC cartridges also wasn’t a big surprise (they even look shady [1]).
The vendor I’ve used in the past for (actual) THC cartridges posts lab tests
for all of their vape products to show there was zero adulterants and they
were doing it _before_ the big scare.

Now we see that it was 100% vitamin E all along (which was used as a
thickening agents for the lowest-quality THC, something glycol-based nicotine
liquids wouldn't need).

[1] [https://hempherbalshop.com/wp-
content/uploads/2019/02/5899D1...](https://hempherbalshop.com/wp-
content/uploads/2019/02/5899D1BA-66BD-4032-A1D4-B26769792734.jpeg)

~~~
cmdshiftf4
>I also noticed a bunch of health agencies took advantage of the headlines to
stir up fear around using them, they never specified what types to watch out
for.

They'd no early insight into what was causing the issues, only that it
appeared en masse at a time where vaping suddenly got very popular, especially
among teenagers.

It would have been negligent of them to try and throw darts at a root cause
without having done the due diligence to research the cases and results
thoroughly, and so it's fair that their warning was about vaping in general.

~~~
rudedogg
It was pretty clear looking at the numbers from the beginning. A high
percentage (I think it was 88%) of the people admitted to using black market
THC vape cartridges. The other people were probably teens too afraid to admit
it. I understand they can't give the all clear, but the headlines and
statements by the CDC were vague and pointed toward nicotine products.

As an example, look at [https://cdc.gov](https://cdc.gov). The hero points to
[https://www.cdc.gov/tobacco/basic_information/e-cigarettes/s...](https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-
lung-disease.html). Why is "THC" buried here?

The way this entire thing was handled makes me not trust the CDC. The fear-
mongering was/is on par with clickbait farms.

------
CoolGuySteve
This reminds me of defective/poisoned alcohol in the prohibition era causing
blindness and whatnot.

If you're going to create a black market via regulation, you better be damn
sure the cure isn't worse than the disease. In marijuana's case, that's
definitely not true.

The book Reefer Madness by Eric Schlosser covers the unintended consequences
of black markets in depth and I can't recommend it enough. But pretty much any
Schlosser book is great.

~~~
dehrmann
The denatured alcohol during prohibition was a government attempt to prevent
people from drinking. This was manufacturers allegedly (the reason isn't
clear) cutting THC with something that's safe for ingestion, but not
inhalation.

The motivations are completely different.

~~~
CoolGuySteve
If your assertion is that _all_ tainted liquor during the prohibition era came
from the government then you're going to have to provide a source, because
that's simply bullshit.

The safety risks of cheaply/poorly made moonshine are well documented:
[https://en.wikipedia.org/wiki/Moonshine#Safety](https://en.wikipedia.org/wiki/Moonshine#Safety)

~~~
dehrmann
It's still different because that's shoddy manufacturing. Vitamin E is an
additive, so it's more intentional.

~~~
drawkbox
If it is 'intentional' it still could be sabotage.

A decade of no issues like this then suddenly a bunch at the same time the
bigs are buying into vaping and the legal market for marijuana is growing. The
blue ocean of vaping and marijuana is here, both the black market
mafias/cartels and the big fish want it and to shakeout the small/medium
suppliers you need an event like this. Not to mention the anti-smoking and
cigarette lobbies in with the prohibitionists and presidential and governor
executive orders, mere months after Altria buys into Juul (Dec 2018), very
sketchy and suspect. Top it off it is a big target of propagandists and bot
networks right now. Add all that up and it seems like a planned event after
sabotage.

The bigs and the mafias/cartels can weather the storm, the small startups and
small/medium businesses that have made safe products for over a decade are the
target of attack.

In my opinion it was market sabotage on purpose. Every new blue ocean market
has events like this and it is from various sources: big fish, underground
mafias/cartels, prohibitionists, authoritarians, puritans and moral patrols.

This is America.

People not thinking it is about market power and money are naive as hell.

You think this is for health reasons? laughable. From the country that can't
even get healthcare to everyone?

Same with all bans and prohibitions, makes it more unsafe and more lucrative
for mafias/cartels because there is decreased supply and increased demand,
price goes up, in comes the underground and big fish and more danger.

~~~
narag
So that vaping Vitamine E gives you cancer was a known fact? How do they know?

~~~
drawkbox
Vitamin E doesn't give you cancer, the Vitamin E filler Acetate that cheap
production was using to stretch supply is not good for your lungs and creates
this sickness.

What is known to cause cancer is carcinogens and vaping does not combust like
cigarettes so that is 20+ less carcinogens going into lungs.

Smoking isn't healthy, but smoking cigarettes is way less healthy and more
damaging. Not only for cancer but for heart and circulatory issues. However
people smoke all their lives, most of that damage is prevalent at the end.

People should have a Right to Body and there should be safety/health alerts
like there are with smoking to let people decide on their own, bans and
prohibitions only make the product people _will_ use more dangerous and
unsafe, as well as create cartels/mafias that make _everyone_ unsafe.

~~~
narag
Well I meant that, whatever substance is the cause, if it was intentionally
introduced, then someone had to know in advance it would be harmful and at the
same time it couldn't be common knowledge or it would have been banned. If
that's what happened, then how can the accusation hold? How would anybody
prove it?

------
beefman
Better sources (take your pick):

[https://www.sciencenews.org/article/vitamin-e-acetate-
culpri...](https://www.sciencenews.org/article/vitamin-e-acetate-culprit-
deadly-vaping-outbreak-cdc-says)

[https://www.cdc.gov/tobacco/basic_information/e-cigarettes/s...](https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-
lung-disease.html#what-is-new)

[https://www.cdc.gov/mmwr/volumes/68/wr/mm6845e2.htm](https://www.cdc.gov/mmwr/volumes/68/wr/mm6845e2.htm)

~~~
gpm
I can appreciate the value of linking to the CDC directly, but I'm curious
about why you think the science news article is better than the nytimes one?

------
colordrops
Why is the media, continuously and erroneously tying tainted THC cartridges
with flavored nicotine vapes targeting children? It's not just one time
either. There's an interstitial on NPR which offers an informational website
about the dangers of flavored nicotine to address the toxic cartridges. It's
completely illogical, which makes me think that some sponsor is pushing an
agenda.

~~~
whamlastxmas
Tobacco companies want to kill vaping and replace it with heated tobacco.
They're pushing this.

~~~
grandmczeb
What evidence is there that tobacco companies are been behind the anti-vaping
movement? I’d love to be proven wrong, but as far as I can tell the only
reason people say this is because they’re an easy whipping boy. IMO, it’s
primarily driven by a crusade of parents and real anti tobacco groups (e.g.
Tobacco Free CA.)

~~~
eurasiantiger
Tobacco addiction is about monoamine oxidase inhibition and its tendency to
make nicotine extremely habit-forming. Tobacco smoke contains various MAO-
inhibiting chemicals, which are the primary reinforcing agent.

Vapes do not contain monoamine oxidase inhibitors, only nicotine. They are
significantly less habit-forming, and the tobacco companies know this.

Edit: except Juuls, which are tobacco extract vaporizers and almost certainly
contain MAO inhibitors.

~~~
grandmczeb
That's not evidence, that's a motive. On the other hand it's a fact that
tobacco companies have spent money on campaigns against various e-cigarette
bans[1] and publicly argued against them as well[2].

[1]
[https://www.opensecrets.org/news/issues/e-cigarettes](https://www.opensecrets.org/news/issues/e-cigarettes)
[2] [https://prospect.org/health/big-tobacco-lobbied-to-save-
vapi...](https://prospect.org/health/big-tobacco-lobbied-to-save-vaping-juul-
altria/)

------
dr_dshiv
It costs $0.06 cents to manufacture a pack of cigarettes. Cigarette companies
have a HUGE incentive to suppress vaping -- and I suspect they played no small
role in the PR against vaping. While Altria bought Juul, it had no long term
competitive advantage. Altria has no capacity to compete in a future where
smoking is a technology. We were watching smoking get disrupted by a safer and
better technology. That is a huge risk to big tobacco. Cigarettes will be
tolerated by governments and the companies will make big profits from a small
number of consumers, year after year.

------
velox_io
This problem isn't down to vaping, it's black-market THC products that were
the problem. The ingredients in vape products are very safe (similar formation
to the ingredients in asthma inhalers, and many other places).

Yes, a dozen or so people have died from this, but this is a fraction of the
500,000 people die per year from smoking-related deaths in the United States
alone.

You have to seriously question the motives behind the "Vaping Deaths!"
headlines. Most things in excess are harmful; food, even water! It's all a
question of context, and how safe something is compared to the alternatives.
Instead of encouraging people to move from smoking to vaping, quite the
opposite is happening, like trying to ban flavoured vaping products for
instance. There's underage drinkers, but banning any type of flavoured alcohol
product would sound ridiculous.

I vape CBD as it is the most effective way to consume it to reduce muscle
spasms. I have never smoked, I hate smoking, and that's before my dad died
from lung cancer. So I have been following the story very closely, it's
actually quite scary how low public health factors in the scheme of things.
Big tobacco is still very big (and powerful).

~~~
goldcd
I'd like to think of it as 'big tobacco' \- but most of them own vape brands,
so would have thought they'd be most happy to carry on selling nicotine
products, without being beaten up with them killing people.

Now - I don't think big tobacco is 'clean' here. EU's "Tobacco Products
Directive" was pretty much written to hand the market to large suppliers
selling small refills.

My guess is that it's just the latest 'think of the children' scare. Juul and
teenagers seem to be the main cause/victim here. Seems to gloss over the
'fewer teens are smoking' benefit here. We had novels, rock music, gansta rap,
video-nasties, murder-simulator games... and now we have vaping. Eventually
we'll get over it.

------
somehnguy
Surprise, what everyone in the e-cig industry has been saying all along. Many
states have already started implementing very restrictive electronic cigarette
laws though (to save the children of course). A few small e-cig shops near me
have been gutted due to the new overly restrictive regulations. Protecting big
tobacco's interests? Mission accomplished.

------
gpm
> Some patients say they vaped only nicotine, and state health officials
> consider some of those reports reliable, Dr. Schuchat said.

A good warning to ignore all the people on HN who keep trying to insist that
"oh, vaping is safe as long as you aren't doing X".

We have no idea if vaping is safe. We still have no idea if vaping is safe,
except we explicitly know it is unsafe (to the point of acutely poisoning you)
if it involves this chemical.

~~~
hn_throwaway_99
But by your same logic, while we might not have a 100% guaranteed idea that
vaping is safe (I disagree we have "no idea", especially compared to other
forms of tobacco use), but we _do_ have a 100% guaranteed idea that smoking
cigarettes is unsafe.

I certainly get all the hate against Juul - it is definitely well-deserved.
But I still think vaping has an actual use case for people who are addicted to
cigarettes who want another way to satisfy their nicotine cravings, especially
in social situations.

~~~
theincredulousk
Agree with you, except the qualifier that “I certainly get all the hate
against Juul”.

I certainly don’t get it. Saw the news on a TV in a bar last night, talking
about the Vitamin E oil. The video clip to go along was someone using a Juul!
Juul is getting conflated to be synonymous with vaping, and that is patently
wrong. I guess they should be sorry for creating the best product, that so
happens to be discreet enough for teenagers to hide.

~~~
hn_throwaway_99
Juul's marketing and advertising in the early days was pretty much designed to
get teenagers hooked.

------
hurrdurr2
Turns out breathing in large quantities of oil droplets is really bad for your
lungs...

Now perhaps they can stop the hysteria and put in some effective regulatory
control instead.

~~~
velox_io
Do you really believe zero oil/ fats from food makes it down the trachea? Of
course it does! Plus you breathe in all manor of pollutants. It's a little
like radiation; natural radiation is everywhere and you cannot avoid it, it
becomes a major problem when the body is exposed to more than the body can
safely remove/ recover from.

~~~
AQuantized
I think "large quantities" is the key part.

~~~
velox_io
Yes, very much so.

------
IXxXI
What happened to previous reports claiming vaping cartridges were tainted with
hydrogen cyanide? [https://www.nbcnews.com/health/vaping/tests-show-bootleg-
mar...](https://www.nbcnews.com/health/vaping/tests-show-bootleg-marijuana-
vapes-tainted-hydrogen-cyanide-n1059356)

------
neonate
[http://archive.is/1EoWq](http://archive.is/1EoWq)

------
notadoc
Total media/moral panic about a virtual nonissue.

------
drawkbox
The market was sabotaged plain and simple because the big fish are moving in.
The result will be regulatory capture that make sure the small/medium
companies that created the market hand it over to the bigs.

Vaping oil is much different than vaping flower or dry. Vaping simply means
non combusted smoke which since it is under 450 degrees it reduces and removes
20+ carcinogens.

Noone thinks smoking is purely healthy, but comparing vaping to cigarettes it
is a no brainer safer. Oils probably a little less safe than dry.

Also, cigarette butts are next to plastics as the most environmental damage.
e-cigs and vaping is mostly re-usable and there are no butts about it.

A decade of vaping, no issues. Suddenly lots of bunk production where the
problem isn't nicotine or THC it is people trying to stretch supply by putting
in harmful filler (vitamin E oil). If you ask me that is blue ocean market
sabotage. The big fish are moving in.

I predict the market of vaping suddenly being "safe" when the bigs are in. It
was safe before, until it was sabotaged for the misinformation/disinformation
to create the outrage and distraction. It is almost too easy with our social
tabloid outrage market now to manipulate to keep the big fish richer and
richer, while people fall for the scam.

Prohibitions and banning does not work, makes it more unsafe and obliterates
harm reduction.

Safe markets that are convenient and available beat black markets. But you
shouldn't help the bigs squash the small/medium that are already testing
within their states in their respective legal state limited markets. This
happens at the beginning of all large new markets that are blue oceans, the
shakeouts happen on the regular by the bigs.

The legal market here shows how it can improve these areas and find issues
quickly. This was a black market sabotage move that was quickly rooted out. It
has been turned into another authoritarian prohibitionist banning movement
using children again. Overreaction and banning ONLY helps the big fish or the
black market, makes everything more unsafe and obliterates harm reduction.

The big fish can weather this storm, the small/medium that were doing it right
cannot and you just side with the big fish when you do this. Nearly all
prohibitionists/authoritarian people end up doing that just like in this case.

Vaping is already illegal by age, no need to harm adults that have Right to
Body. We need a Right to Body amendment that could have a whole political
party around it, it could change the world. It would remove all laws and
illegality around owning your own body including: drugs, sex/sex working,
choice, etc for adults and legal markets that are safer.

Parents need to step up to stop kids from vaping under age. We don't need the
whole country or government to be Big Daddy, that is what an authoritarian
system has like China or Russia.

Companies shouldn't be able to market them like cigarettes or alcohol, but
taking from all because of a few ends up in tyranny, even if you think that
small step is harmless, it is not. Otherwise they'll start banning video
games, sodas, food, candy, coffee, etc etc.

You have to understand human nature, anything banned increases in value due to
black market, anything legal where clear information gets out, starts to help
the issue and safer production. Just like in this case, the market was legal,
the problem was found to be Vitamin E Acetate quickly.

Think it isn't black market or big fish sabotage? Note the time when Altria
bought in Dec 2018 and note when the outrage happened, 2019, see a timeline
pattern? [1] Stay tuned, they need people temporarily being against this to
win this market as well, keep up the outrage for nothing and they will win.

"But think of the kids!!" Oldest trick in taking over markets disaster
capitalist big fish book.

Will you still be saying "think of the kids" when they ban reddit? How about
video games, sodas, food, candy, coffee, etc etc? There are plenty of
prohibitionists that want to ban all of that and have tried with cases like
this many times. They even tried with reddit for FOSTA-SESTA bills after the
Craigslist/Backpage classified section shut down because the bigs wanted that
and it was one of those "think of the kids" moments that ended up being
complete lies [2].

Prohibitions and banning never works on things people choose to do with their
own bodies, it will only benefit the black market and the wealthy big fish as
well as the cartels/mafias.

Nearly all authoritarian prohibitionist people end up helping authoritarian
and big fish in the market just like in this case.

Altria will benefit the most, they can take the temporary setback and it is
even some false opposition going on to help this. Juul was bought into
recently (2018) and the outage started months after (2019) [1]. Altria also
ousted the CEO from before, now they will be able to own more of it with
reduced value. This was a simple disaster capitalist big fish play and
prohibitionists fell for it.

Prohibitionists are out here fighting for big fish killing off innovative
small/medium companies that were doing it right. If you are in the outrage
state, pro-prohibitionists and own it, you are letting the big fish take the
market from the small/medium players that were doing it right, or the black
market mafias/cartels.

This had nothing to do with the legal market, the legal market is the only way
forward with age limitations and safety testing/regulations that don't squash
the small/medium at this stage.

Just be aware, the bots and trolls are out pushing this. The President looks
to be doing an Executive Order soon to limit vaping while easing up on
cigarettes, just like all the Republican governors that did it. [3][4] Same
play different day, big fish win, "think of the children" authoritarianism and
big fish disaster capitalist raiding of the blue ocean that will be immense
when marijuana is fully legalized and vaping is suddenly "safe" when the bigs
run the show.

This is America.

People not thinking it is about market power and money are naive as hell.

You think this is for health reasons? laughable.

Same with all bans and prohibitions, makes it more unsafe and more lucrative
for mafias/cartels because there is decreased supply and increased demand,
price goes up, in comes the underground and more danger.

[1] [https://www.npr.org/2018/12/20/678915071/altria-
buys-35-perc...](https://www.npr.org/2018/12/20/678915071/altria-
buys-35-percent-stake-in-e-cigarette-maker-juul)

[2] [https://www.wired.com/story/inside-backpage-vicious-
battle-f...](https://www.wired.com/story/inside-backpage-vicious-battle-feds/)

[3] [https://www.nytimes.com/2019/09/11/health/trump-
vaping.html](https://www.nytimes.com/2019/09/11/health/trump-vaping.html)

[4] [https://www.bloomberg.com/news/articles/2019-11-08/senior-
wh...](https://www.bloomberg.com/news/articles/2019-11-08/senior-white-house-
official-says-fda-shouldn-t-regulate-tobacco)

------
vfclists
[https://www.youtube.com/watch?v=JXRN_LkCa_o](https://www.youtube.com/watch?v=JXRN_LkCa_o)
1:26, 1:30, 1:32, 2:18, 2:25, 2:28

Is it ethical to target young people so blatantly in this manner? Does the
fact that they are habit forming mean nothing to industry and advertisers?

I guess the chickens are coming home to roost

~~~
Esthrowaway123
Is it ethical to listen to Chris Brown after reading the police report of how
he beat the shit out of his girlfriend?

~~~
ghemsley
Ethical? Depends what he is saying, and whether it's true/reasonable or not. I
think you meant to ask whether it's still politically correct, and the answer
would be 'probably not'.

