Vaping Related Illness Hospitalizations in Steady Decline

Published: March 18, 2020

Vaping Related Illness Hospitalizations in Steady Decline

The Canadian Vaping Association (CVA) is concerned by comments in the article “Vapotage: six cas de maladie pulmonaire grave au Québec,” published by La Presse:

The Association des pneumologues du Québec is also concerned about the first cases of serious illnesses related to vaping. Its president, Dr Antoine Delage, points out that different types of lesions are observed in sick patients, which suggests that several diseases could be linked

As a result the CVA has released the following statement:

None of the science to date has shown any connection between nicotine vaping and EVALI. At the time of the outbreak, the CVA urged public health officials to investigate contaminated black-market THC vapour products. The CDC has concluded that the principal cause for the lung illness was vitamin E acetate. The nicotine vapour industry does not use such additives. Vitamin E acetate is prohibited under the Tobacco and Vaping Products Act (TVPA), which governs the manufacturing of nicotine e-liquid products in Canada.

During the outbreak, medical professionals and the CDC used self reported information from the patients to determine which products they had used. 14 percent of the patients reported they did not use THC containing vapour products, reporting they had only used nicotine vaping products.

Patients were tested for THC, and in many cases those who denied using illicit THC products, tested positive for THC or later admitted to having used it. The CDC has stated these patients may have feared legal repercussions from using an illegal substance.

In some cases, test results came back negative for THC, while still being found to have vitamin E acetate in their lungs. Experts have concluded that the THC was likely already eliminated from their system, yet the vitamin E acetate remained. As vitamin E acetate is prohibited in nicotine vapour products, experts agree it is highly likely that all patients were exposed to illicit THC vapour products.

Moreover, the CDC tested nearly 200 commercial nicotine e-liquid products that patients reported having used and they found no traces of contaminants or vitamin E acetate. These same products were used by millions of other vapers who were unaffected by the illness. From the data available, experts have concluded that patients either mislead authorities about their product use, or their condition can not be confirmed as vaping related.

An article published by The Wall Street Journal, “Vaping – Related Deaths Fall”, included data on hospital admissions for vaping related illness. After a spike in hospitalizations beginning in late August 2019, the rates then steadily decline to zero admissions. The data makes two things clear:

  1. Prior to the introduction of THC cartridges on the black market, traditional nicotine vaping was not causing illness. 
  2. Notifying the public of the dangers of THC vapour products containing vitamin E acetate caused a rapid decline in hospitalisations.

We suspect that the end to vaping related illness is two-fold. Creating public awareness around the true culprit of the illness enabled the public to avoid harmful products. Additionally, the black market has now had time to correct this grievous error. The CVA strongly urges the public to exercise caution with regards to THC containing vapour products. All nicotine vapour products should be purchased from a licensed specialty vape store.

It is regrettable the public announcement of vitamin E acetate as the cause for the outbreak did not come sooner. The hysteria surrounding vaping caused many adult vapers to return to combustible tobacco, a product which we know will kill one in two smokers. We hope with the data indicating an end to vaping related illness, and the cause identified, smokers will consider vapour products as a means of harm reduction, a method The Royal College of Physicians maintains is 95 percent less harmful than traditional cigarettes.

The UK Government has published its sixth annual, “Tobacco Control Plan for England”. For the sixth consecutive year, the UK has reaffirmed that vaping is still less harmful than smoking.

“The mistaken belief that e-cigarettes are more harmful than smoking increased rapidly among UK smokers following the US lung injury outbreak in autumn 2019. US authorities have now confirmed that vitamin E acetate, a thickening agent added to cannabis vaping products, was a primary cause of the US outbreak. This substance is banned from UK-regulated nicotine vaping products. E-cigarettes are not completely risk free but when compared to smoking, evidence shows they carry just a fraction of the harm. The problem is people increasingly think they are at least as harmful and this may be keeping millions of smokers from quitting. Local stop smoking services should look to support e-cigarette users in their journey to quitting completely.”