January 14, 2020
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Most THC products linked to vaping-related lung injuries from ‘informal sources’

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Most patients with electronic cigarette- or vaping-associated lung injuries, or EVALI, who used products with THC acquired the products from informal sources like family and friends or dealers, according to findings published in the Morbidity and Mortality Weekly Report.

“The reported use of THC-containing products from informal sources by most EVALI patients is important because vitamin E acetate has been detected in products obtained from these sources and has been associated with EVALI,” Sascha Ellington, PhD, an epidemiologist at the CDC, and colleagues wrote.

Ellington and colleagues provided an update on EVALI patients’ characteristics and self-reported THC and nicotine vaping sources as of Jan. 7, based on data provided to the CDC by state health departments.

Among 1,979 patients with EVALI who had information available on their substance use, 82% reported using any products that contained THC and 34% reported that they only used products with THC. Fifty-seven percent of patients reported using any products that contained nicotine, and 13% reported only using nicotine products.

Image of woman vaping.  
Most patients with electronic cigarette- or vaping-associated lung injuries, or EVALI, who used products with THC acquired the products from informal sources like family and friends or dealers, according to findings published in the Morbidity and Mortality Weekly Report.
Source: Shutterstock

Half of patients who reported THC product use (n = 809) had information available on where they obtained these products. Just 16% of those reported that they obtained the products from recreation or medical dispensaries, vape or smoke shops, stores or other commercial sources.

Meanwhile, 78% reported that they only obtained THC products through informal sources. Of those, 38% got the products from family and friends, 31% from in-person or online dealers, and 23% from other sources.

For patients who reported using any nicotine products and where they received the product (n = 613), 69% said they used only commercial sources and 17% reported only informal sources.

Younger patients were more likely to obtain both types of products from informal sources. For THC, 94% of patients aged 13 to 17 reported getting it from an informal source, compared with 62% of patients aged 45 to 77 years. For nicotine products, 42% of patients aged 13 to 17 years reported an informal source, compared with 12% of those aged 45 to 77 years.

Although vitamin E acetate has been linked to THC-containing vaping products and EVALI, researchers noted that more research is needed to determine if there are additional causes of the outbreak.

“Therefore, while the investigation continues, CDC recommends that the best way for persons to ensure that they are not at risk is to consider refraining from the use of all e-cigarette, or vaping, products,” Ellington and colleagues wrote. – by Erin Michael

Disclosures: The authors report no relevant financial disclosures.