
Vaping-related lung injuries primarily linked to black-market products - lysp
https://cei.org/blog/cdc-confirms-black-markets-not-%E2%80%9Cvaping%E2%80%9D-caused-outbreak%C2%A0
======
ng12
I hope this spurs the government into action. NYC is absolutely flooded with
perfectly legitimate looking vape cartridges filled with questionable product.
They're often sold as being from a "dispensary brand" although they're
obviously not. As an example, these were readily available for years despite
the fact that the brand never even existed in the first place:

[https://merryjane.com/culture/are-smart-cart-vapes-legit-
and...](https://merryjane.com/culture/are-smart-cart-vapes-legit-and-what-do-
fakes-look-like)

~~~
pkaye
How would the government identify what is legitimate?

~~~
DoingIsLearning
Regulate the same way the FDA regulates all other products.

As someone outside the US who has to work with the FDA, Americans should be
very proud of how thorough FDA inspectors are at auditing and how good they
are at identifying non-conformances and just plain criminal lack of due
diligence.

There is a database of 'offenders' that are no longer allowed to sell their
products it's seriously scary what some companies/people are willing to do for
a quick buck.

You could argue that in the US there is a considerable amount of lobbying and
influence that defeats the impartiality of some federal bodies but overall
they do an amazing job at keep everyone safe.

~~~
Gatsky
Why should the FDA use up government resources to regulate vaping?

Put another way, why do we think the solution for people with no integrity or
no clue or both trying to make money out of vaping (Juul included) is to spend
taxpayers money helping them behave themselves?

I find this attitude pretty crazy to be frank. Consider that whatever happens
from here, however much joy everybody gets from vaping and blowing smoke in
the future, it isn’t ever going to be worth 50 dead people.

There is that, and then Juul pretending to be a benefit to society while
getting children addicted to nicotine and then selling themselves to big
tobacco... what exactly is the benefit of vaping? The argument it minimises
the harm from smoking is nonsense and unproven. There are well established
methods of reducing smoking on a societal level (put up the taxes), which
return money to the government to pay for all the negative externalities of
smoking which big tobacco isn’t held accountable for.

Anyway, the USA has a funny attitude about these things. Personal choice and
optionality are considered paramount. Someone else can pick up the pieces.
Applying it everywhere is obviously flawed if you ask me.

~~~
hurricanetc
You could apply this to virtually any product category. Liquor, beer, tobacco,
soda, meat, toothpaste, soap, on and on and on.

Well you don’t need soda it’s a vice so we aren’t going to regulate it and
make sure products are safe.

Who defines the start and end for what should be regulated? You? Legal
products in the US should be safe to purchase. If marijuana is legalized it
should be safe to purchase also.

~~~
Gatsky
I don’t see your point. I argue vaping should be banned. All those other
things you list are already in widespread use, it’s irrelevant.

~~~
hurricanetc
You actually didn’t argue that.

Alcohol and tobacco are in use but surely we could save money by making them
illegal. Why waste money and continue to regulate?

Again, who is deciding? Is it you? It should be illegal because... reasons?
Reasons that don’t apply to other vices because... reasons?

------
WheelsAtLarge
The big problem seems to be that vaping has never been proven to be safe or
safer than cigarettes. There's always been the assumption that it is.

My suspicion is that something like this outbreak will happen again.

I'm not a fan of the vaping companies since their goal seems to be to get
users addicted to their product but they should go through the process of
proving that vaping is safer than cigarettes so they don't get blamed for the
next outbreak. And cigarette users have a choice that's less harmful than
smoking cigarettes.

~~~
TylerE
Cigarettes kill almost 500,000 people a year in the US alone.

We could have 10 of these "outbreaks" a _day_ and still be way ahead.

~~~
tjohns
That assumes there’s no long term cancer risk from vaping, which we simply
don’t know yet.

~~~
mistermann
Is there any plausible theoretical basis for a cancer risk from vaping?

~~~
berbec
Nicotine is a carcinogen

~~~
parliament32
Nicotine is not a carcinogen.

[https://thorax.bmj.com/content/66/4/353](https://thorax.bmj.com/content/66/4/353)

[https://stacks.cdc.gov/view/cdc/21569/Share](https://stacks.cdc.gov/view/cdc/21569/Share)

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553893/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553893/)

------
pbreit
This seemed pretty obvious when all the stories were about cannabis vaping,
not nicotine.

And now vaping is thought to be unhealthier than tobacco smoking.

~~~
Stratoscope
The stories were never about cannabis vaping either. They were about
_adulterated cannabis extract_ vaping.

Someone using a cannabis flower vaporizer (e.g. PAX 2/3, Firefly, Arizer,
Volcano) with pure lab tested flower was never at risk for the lung disease
that vitamin E acetate has caused.

The linked article doesn't mention vitamin E acetate, so here's one that
discusses it:

[https://www.theverge.com/2019/12/20/21031771/vaping-lung-
inj...](https://www.theverge.com/2019/12/20/21031771/vaping-lung-injuries-
vitamin-e-acetate-cdc-thc-chemical)

~~~
catalogia
> _pure lab tested flower_

There has been some trouble with that too. Washington state doesn't require
lab testing for pesticides, and in other states there have been cases of
fraudulent testing ([https://www.nbcbayarea.com/news/local/industry-insiders-
warn...](https://www.nbcbayarea.com/news/local/industry-insiders-warn-of-
fraud-at-marijuana-testing-labs/37979/)
[https://www.leafly.com/news/industry/sequoia-analytics-
surre...](https://www.leafly.com/news/industry/sequoia-analytics-surrenders-
license-for-faking-lab-data) )

The industry is still maturing and I'm confident things will get better with
time. But for the time being, consumers should exercise reasonable caution.

~~~
thebigspacefuck
There have been a few issues due to mold and yeast contamination too. Still,
better than the black market days because you can check the serial number
against the contaminated batches.

------
icanhackit
Given the highly localised and sudden/synchronised bout of illness associated
with vaping, to me it immediately seemed reasonable to assume contamination of
a specific batch of products rather than the act of vaping in general being an
issue.

I'm not saying vaping doesn't perhaps have long term negative effects, just
that the pattern of illness suggested an issue with specific products.

~~~
brokensegue
it wasn't a contaminated batch. we know what caused it. it was a particular
formulation of vape juice used by multiple suppliers.

~~~
icanhackit
That's what I meant. Specific products were using a harmful substance, rather
than the act of vaping causing illness.

~~~
brokensegue
ok sure. contaminated often implies some kind of accidental addition of
harmful substances which isn't the case here which is what I was clarifying.

------
pergadad
This seems to be a rather simplistic/one-sided answer furthering a specific
agenda.

* The responses that don't fit the narrative that 'legal' vaping is safe are'explained away' in this article - that's just unscientific and a matter of ignoring contrary evidence. * There are other dangers to vaping ignored in the argument (eg addiction, kids starting even earlier if there's 'bubblegum' or 'cherry' flavour rather than tobacco * No long term studies, so we really have no idea what's safe and what's not. * Overall there's no control or standards on the stuff in the vaping juice, so we still don't really know what effect which product might have. * The bans were not motivated just by the sick people but also the various other factors - so even if true that 'legal'vaping products weren't the cause there are many questions still to be answered. * ...

The world is never so black and white as this article paints it.

A) Is vaping better than cigarettes? Maybe. Is it better people switch to
vaping? Maybe. Is it better we encourage/aid them to stop smoking and vaping?
Absolutely.

B) Will flavoured vaping with sweet flavours, wild west unlicensed/non-
regulatef ingredients and unchecked advertising get more young people and even
children interested and hooked? Absolutely.

~~~
himinlomax
> Is vaping better than cigarettes? Maybe

There is simply no plausible way it's not.

> Will flavoured vaping (...) get more young people and even children
> interested and hooked? Absolutely.

What is known about cigarette and nicotine addiction makes it actually quite
unlikely. Nicotine alone does not seem that addictive, in any case it's
definitely much less addictive than nicotine plus the combustion products
found in tobacco. Cf
[https://www.ncbi.nlm.nih.gov/pubmed/16177026](https://www.ncbi.nlm.nih.gov/pubmed/16177026)

------
g82918
Very early on scientists identified vitamin E additives as being the cause.
Most black market vapes added vitamin E acetate ,etc.. to enhance the flavor
profile of the "carts". Overall this isn't super surprising.

~~~
mikeappell
I'm not sure if it was so much the flavor profile as it was being used to thin
out the product using an inexpensive thinning agent. THC concentrate is _very_
viscous, and needs to be cut with something to be viable for cartridge use.

Iirc terpenes are used in higher quality products.

~~~
eurleif
From what I've read, the primary goal was to cut it _without_ thinning it very
much, in order to pass the "bubble test". Consumers would test viscosity by
observing how quickly the airbubble in the cartridge moved. Vitamin E acetate
is thick enough to deceive people into thinking the cartridge wasn't cut.

------
KnightHawk3
What's the state of all the laws brought in against vapes under the pretence
that nicotine vaping is causing the outbreak in lung illnesses.

~~~
MiroF
I think there are two related problems -

one is contamination of black market carts

the other is the rise of teenage nicotine intake

My understanding is many of the federal laws are meant to address the latter,
while the local laws like the MA vape ban meant to address the former are now
being rolled back.

------
claar
This article is an obvious propaganda piece. The CDC findings linked within,
while boring to read, at least provide a more neutral view.

~~~
icanhackit
> This article is an obvious propaganda piece.

They're clearly an advocate for vaping, however title [1] and summary are
accurate. Per the CDC study:

"Among EVALI patients reporting use of any THC-containing products, 122 of 130
(94%) of those aged 13–17 years acquired products through only informal
sources"

"A recent case-control study found vitamin E acetate in the bronchoalveolar
lavage fluid of 94% of 51 EVALI patients and in none of 99 healthy controls in
the comparator group (4)."

"In addition, an analysis of THC-containing products seized by law enforcement
in Minnesota found no vitamin E acetate in 10 products seized in 2018, and
100% of 20 products seized in 2019 contained vitamin E acetate (5)"

[1] CDC Confirms Black Markets, Not “Vaping,” Caused Outbreak

------
rjmunro
The Freakonomics podcast covered this:
[http://freakonomics.com/podcast/vaping-
nicotine/](http://freakonomics.com/podcast/vaping-nicotine/)

------
knolax
If the headline says that the CDC confirms something, shouldn't a CDC press
release or paper be used? Article seems to be from some third party citing
this paper[0] and claiming they predicted it before. Title seems a little
misleading.

[0]
[https://www.cdc.gov/mmwr/volumes/69/wr/mm6902e2.htm?s_cid=mm...](https://www.cdc.gov/mmwr/volumes/69/wr/mm6902e2.htm?s_cid=mm6902e2_w)

------
resters
And again, just as was the case with Boeing, the blame lands squarely on the
shoulders of regulators who failed to adequately do their jobs.

In the case of Boeing, the regulatory approach was a joke, and in the case of
vaping, regulators had their heads in the sand about a multi billion dollar
black market for years.

The death toll resulting from backward recreational drug regulation in the US
is mind boggling, not to mention all those still suffering in prison.

People have a knee-jerk reaction of blaming firms and assuming that regulators
are doing their best, when in fact regulators are the ones who create the
entire (black, gray, etc.) market landscape for all participants to operate
in.

~~~
allovernow
How do you regulate an illegal black market?

~~~
resters
Just as many regulatory approaches don't work, outright bans is one that
clearly doesn't work. They are rooted in a backward, dualistic view of the
world.

In the case of banning recreational drugs, the history of those laws is among
the ugliest bits of American history.

The practice of allowing firms to self-regulate crucial aircraft safety
practices is also very foolhardy.

When will we start holding the right parties responsible for all these
tragedies? We the people need to insist that regulators step up and make us
safer, not cater to whatever interest group has achieved regulatory capture.

