While Vitamin E is consumed via foods, dietary supplements, and even included in many cosmetic products like skin cream, officials at the United States Food and Drug Administration (FDA) identified Vitamin E acetate as a common component in many of the marijuana vaping products and oils that have hospitalized thousands with vaping-related illness and injury (EVALI), even resulting in death in some cases.
Full Answer
What is vitamin E acetate Vape liquid?
Vitamin E acetate is an oily chemical commonly added to THC vaping liquids to dilute or thicken them; the substance has been acknowledged as a potential toxin of concern by the Center for Disease Control and Prevention (CDC), due to its ability to remain in the lungs for long periods of time, and therefore cause complications in the lungs.
What is the role of vitamin E acetate in evali?
Vitamin E acetate has been identified as a chemical of concern among people with e-cigarette, or vaping, product use associated lung injury (EVALI). THC is present in most of the samples tested by FDA to date, and most patients report a history of using THC-containing e-cigarette, or vaping, products.
What is vitamin E acetate and why is it dangerous?
CDC has detected vitamin E acetate as a chemical of concern among people with the lung injury. Vitamin E acetate is a condensing agent in vaping products, and all injured lung fluid samples appear to harbor this agent.
Is there vitamin E acetate in cannabis products in Canada?
The vitamin E acetate targeted method presented here was not applied to any cannabis-containing vaping products, therefore, no conclusions can be made on presence of this diluent in cannabis products in Canada. Vitamin E acetate (D, L) emissions in our study were generated using 96% pure compound.
See more
Do vapes still contain vitamin E acetate?
To date and to our knowledge no nicotine-vaping liquids have been reported to contain Vitamin E Acetate.
Is vitamin E acetate in regular vape juice?
Specifically, vitamin E acetate is most commonly used as an additive in THC-containing vape/e-cigarette products; vitamin E acetate is an oily chemical added to THC vaping liquids used to thicken or dilute them.
Why is vitamin E acetate in vape juice?
The vitamin has been found as an additive in vaping products, especially those containing THC, either as a thickening agent or dilution to make the oil in cartridges go further.
How common is EVALI?
EVALI was initially recognized in the summer of 2019 [3,7-10]. More than 2800 hospitalized cases of EVALI were reported to the Centers for Disease Control and Prevention (CDC) as of February 18, 2020, and, among those, there have been 68 deaths [5].
What is the safest vape to use?
If you are looking for the safest vape kit then you might want to consider disposables or pod kits. These are often low powered and have safety cuts offs as well as other features to prevent them from overheating. Not only as disposables one of the safest vape kits, but they are also super easy to use.
What are the safest vape juices?
If that doesn't appeal to you, check out the best diacetyl-free e-liquids.Black Note. Black Note provides premium e-juice for the true tobacco connoisseur. ... VaporFi. VaporFi is on a mission to change smoker's lives. ... Kind Juice. Kind Juice provides a departure from your typical boring e-juice. ... Cosmic Fog.
What are 5 risks of vaping?
Vaping has been linked to lung injury.Rapid onset of coughing.Breathing difficulties.Weight loss.Nausea and vomiting.Diarrhea.
What happens when u smoke vitamin E?
It has been proposed that vaping induced pyrolysis of vitamin E acetate may produce a highly toxic gas called ketene. Inhalation of ketene can cause severe lung damage in low concentrations and death in high concentrations.
Is vaping worse than smoking?
1: Vaping is less harmful than smoking, but it's still not safe. E-cigarettes heat nicotine (extracted from tobacco), flavorings and other chemicals to create an aerosol that you inhale. Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic.
How long do you have to vape to get EVALI?
Anyone who's vaped in the last 90 days is at risk for EVALI. You don't have to be older or already sick. “Many of these patients were normal, healthy people,” Tsai says.
How do I know if I have EVALI?
What are symptoms of EVALI? Patients in this investigation have reported symptoms such as: Respiratory symptoms, including cough, shortness of breath, or chest pain. Gastrointestinal symptoms, including nausea, vomiting, stomach pain, or diarrhea.
Is lung damage from vaping reversible?
Breathing in the harmful chemicals from vaping products can cause irreversible (cannot be cured) lung damage, lung disease and, in some cases, death. Some chemicals in vaping products can also cause cardiovascular disease and biological changes that are associated with cancer development.
Is vitamin E oil in vape juice?
Some of these additives found in e-liquid are dangerous — even deadly. For example, vitamin E acetate has been indicated in EVALI, which stands for e-cigarette or vaping product use associated lung injury. This is a potentially fatal syndrome associated with vaping, and it was on the rise in 2019.
Is vitamin E acetate in Juul?
Vitamin E And E-Cigarettes According to US Centers for Disease Control and Prevention officials, vitamin E acetate, an additive sometimes used in THC and other vaping products, may be to blame for a national outbreak of e-cigarette-related lung injuries that's linked to dozens of deaths.
What happens if you smoke vitamin E?
It has been proposed that vaping induced pyrolysis of vitamin E acetate may produce a highly toxic gas called ketene. Inhalation of ketene can cause severe lung damage in low concentrations and death in high concentrations.
What are the ingredients in vape juice?
The "e-juice" that fills the cartridges usually contains nicotine (which is extracted from tobacco), propylene glycol, flavorings and other chemicals. Studies have found that even e-cigarettes claiming to be nicotine-free contain trace amounts of nicotine.
What is vitamin E acetate used for?
And vitamin E acetate has reportedly been used as a cheap cutting agent by illicit cannabis suppliers.
What is the culprit in vaping?
Vitamin E acetate is a key culprit in the vaping illness outbreak. The sticky chemical has been found in samples taken from people who got sick or died from vaping-related illness. By Julia Belluz @juliaoftoronto Nov 11, 2019, 10:30am EST. Share this story.
Is there direct evidence of vitamin E acetate in the lungs?
But Schuchat also emphasized the CDC’s investigation isn’t over: Officials still can’ t say for sure that vitamin E acetate is the source of harm in all cases.
Does a medical grade product have to be tested for pesticides?
But only medical-grade products are also tested for pesticides and heavy metals. The list of tests also doesn’t include checking for chemicals, such as vitamin E acetate, that have emerged as a health threat.
Is it safe to inhale vitamin E?
The chemical is a synthetic form of vitamin E, and it’s used — safely — in nutritional supplements and skin creams. But it isn’t safe to inhale. Sticky and honey-like, it can hang around in the lungs, health officials said, interfering with how they function. Samples taken from 29 patients in 10 states, for a CDC Mortality and Morbidity Weekly report released Friday, found the chemical in all samples, while other potential toxins — such as plant and mineral oils — weren’t. It’s “direct evidence of vitamin E acetate at the primary site of injury within the lungs,” Schuchat said.
Abstract
The United States Federal Centers for Disease Control and Prevention (CDC) has been working with state investigators on reported cases of lung illnesses linked to e-cigarette or vaping products.
Similar articles
Characteristics of E-cigarette, or Vaping, Products Used by Patients with Associated Lung Injury and Products Seized by Law Enforcement - Minnesota, 2018 and 2019.
What are the ingredients in vape?
The ingredients of vape that are suspected of contributing to the development of vaping-related illnesses are THC and vitamin E acetate. THC is an ingredient used in many vape products, and many patients experiencing vape-related complications have admitted to using THC-containing products in the past, leading the FDA to believe that THC may play a role in the vape-related illness outbreak. The FDA has issued a public warning to stop using THC-containing vape products, as the compound may be contributing to lung illnesses related to vaping. Specifically, vitamin E acetate is most commonly used as an additive in THC-containing vape/e-cigarette products; vitamin E acetate is an oily chemical added to THC vaping liquids used to thicken or dilute them. A vape-related injury concerning a teenage boy in Canada has recently gained the media’s attention as well. The 17-year-old boy vaped “intensively,” adding THC to his devices. He initially showed symptoms aligning with bronchiolitis (lung condition normally caused by a bacterial or viral infection), but many patients that have vape-related illnesses in the United States have experienced damage to the alveoli; this type of injury was not found. Instead, his case aligned more with an injury called “popcorn lung,” an ailment most commonly seen in factory workers of microwave popcorn plants nearly 20 years ago. This new vape-related case calls for further exploration into the toxicity of vape liquid, as the patient’s condition could have been caused by the THC added to the vaping devices, or the chemical that affected factory workers in the past - diacetyl. Diacetyl is present in many e-cigarette flavors [14]. The American Lung Association has called for the FDA to require that diacetyl and other hazardous chemicals be removed from e-cigarette cartridges.
How many deaths from vaping in 2019?
As of November 13, 2019, there were 2,172 confirmed and probable lung injury cases "associated with the use of e-cigarette or vaping, products as reported by 49 states (all except Alaska), the District of Columbia, Puerto Rico, and the U.S. Virgin Islands as reported by the CDC. 42 deaths have been confirmed in 24 states and the District of Columbia: Alabama, California (4), Connecticut, Delaware, the District of Columbia, Florida, Georgia (3), Illinois (4), Indiana (4), Kansas (2), Massachusetts (2), Michigan, Minnesota (3), Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, Oregon (2), Pennsylvania, Tennessee (2), Texas, Utah, and Virginia" [21]. Vaping, may also have harmful psychological effects with a strong association between vaping, major depression and suicidal behavior as reported in a large new study [22]. The likely contributing culprit, nicotine. Prevalence of lung disease attributable to vaping is likely under reported as cases brought to the CDC are some of the most severe. For now EVALI remains a diagnosis that is made after exclusion of other conditions and needs to be reported to the CDC.
What is the purpose of vaping?
Vaping was initially marketed as a smoking cessation aid to help with cessation of cigarette smoking. E-cigarettes first took public attention in the mass media for unexpectedly blowing up, causing burns and severe facial damage [6]. In the past decade, a number of alternative vaping products have rapidly gained consumer demand, especially in, adolescents, due to the belief that they are much safer (lower nicotine content) than traditional cigarettes, choice of advertisements different flavors and ease of access to electronic nicotine delivery systems (such as e-cigarettes and vape pens). Except for menthol, the use of flavor additives has been banned from traditional cigarettes, whereas e-cigarettes are marketed in over 7,000 different flavors. Many of those flavors are found in candy and popular soft drinks and, because adolescents are familiar with such flavors, e-cigarettes are appealing to them. Tobacco smoking is associated with vascular endothelial dysfunction in a causative and dose-dependent manner [7]. Data from 5,400 smokers and 2,025 former smokers have found that the average number of cigarettes smoked per day by people who regularly used e-cigarettes fell by 4.4 over about two years, compared with only 2.7 for those who did not use e-cigarettes. Sixty-seven percent more e-cigarette users than non-users quit smoking altogether. However, there were 70% more relapses among former smokers who used e-cigarettes than among those who did not use the devices [8].
When were electronic cigarettes invented?
Electronic cigarettes were first developed in China in the early 2000s and introduced to the US market in 2007 [5]. In the US, the product experienced explosive growth, with the number of electronic cigarette users doubling every year between 2008 and 2012. While traditional cigarettes are smoked through combustion, e-cigarettes are "vaped," and the resultant aerosols potentially contain a reduced number of potentially toxic chemicals, such as nicotine and flavorings such as diacetyl and cinnamaldehyde, as well as byproducts such as formaldehyde and acrolein caused by the potential overheating of propylene glycol, and glycerin.
Does vaping affect the lungs?
The evidence on how vitamin E acetate affects the lungs of vape users is notable because vitamin E acetate has been acknowledged as a majorly harmful chemical that may be contributing to vape-related illnesses and deaths. Lung scans have revealed different outlines of lung parenchyma suggesting possible different processes in injury. One pattern points to lipoid pneumonia which can occur with lipid containing ingredients or oils aerosolized into the airways causing inflammation and compromised function [17]. The respiratory epithelium has a complicated network of extracellular membranes essential for breathing and survival. Surfactant membranes form a stable monolayer at the air-liquid interface, reducing the surface tension at the air-liquid interface, therefore stabilizing the lung against collapse and helping lungs expand. Oil in the lung interferes with this ordered/disordered lipid phase coexistence in lung surfactant with alterations in phase coexistence [18]. The American Medical Association has made calls for a ban on vaping products, and Washington state has now banned vape products containing vitamin E acetate, thought to be linked to illness [19-20]. Although the substance is not banned in the United States and has not been officially declared as a deadly substance, many states are making advances to ban the use of the chemical in vape products. States like Massachusetts are considering a ban on flavored tobacco and vape products, and in New York, Manhattan is expected to become the largest city to ban all vaping flavors except tobacco. Other states that have already banned the use of vitamin E acetate in vape products include Colorado and Ohio. Greater public awareness of this deadly condition helps with implementing comprehensive, population-based interventions for this preventable disease.
Is vaping dangerous?
CDC has detected vitamin E acetate as a chemical of concern among people with the lung injury. Vitamin E acetate is a condensing agent in vaping products, and all injured lung fluid samples appear to harbor this agent. The mysterious outbreak is identified in individuals vaping within the 90 days, ranging over a few days to developing over several weeks. There is growing evidence that vaping is hazardous to your health including immediate health dangers such as death from respiratory causes, long term health effects, cardiovascular events, depression which increases the risk of suicidal thoughts and suicide. This review article summarizes the growing knowledge of acute respiratory complications associated with vaping.
Does vaping cause lung injury?
The New York Times recently reported an analysis of lung fluid samples from 29 patients with vaping-related illnesses (including two who died), and the analysis suggests that vitamin E acetate is a "very strong culprit" in causing lung injuries. The lung fluid samples were collected from patients across the United States so that these findings may have implications nationwide. Moreover, Dr. Anne Schuchat, principal deputy director of the CDC, explained, “For the first time, we have detected a potential toxin of concern, vitamin E acetate, from biological samples from patients… The analysis provided evidence of vitamin E acetate at the primary site of injury in the lungs” [15]. Vitamin E acetate is sticky, giving it the ability to remain in the lungs. THC was also reported to be found in 82% of samples from 28 patients, which was remarkable as THC tends to leave the lungs quickly [16].
How may vitamin E acetate lead to vaping-related illness?
She points out that there is a “pretty strong correlation” between vitamin E acetate and EVALI, but there’s no current proof that vitamin E acetate actually causes EVALI —just that it’s been detected in many EVALI patients. Still, “vitamin E is the most likely culprit at this point,” Alan says.
What are the symptoms of e-cigarettes?
E-cigarettes and vaping products cause EVALI, and it’s a serious condition that causes symptoms that are similar to those of pneumonia or the flu. People with EVALI have experienced the following symptoms, according to the CDC: 1 Coughing 2 Chest pain 3 Shortness of breath 4 Abdominal pain 5 Nausea 6 Vomiting 7 Diarrhea 8 Fever 9 Chills 10 Weight loss
Can vaping cause evali?
E-cigarettes and vaping products cause EVALI, and it’s a serious condition that causes symptoms that are similar to those of pneumonia or the flu. People with EVALI have experienced the following symptoms, according to the CDC:
What is vitamin E acetate?
What exactly is vitamin E acetate? Vitamin E is a well-known antioxidant that occurs naturally in vegetables, vegetable oils, seeds, and fruits. Specifically, vitamin E refers to a group of 8 isoprenoid molecules known as tocochromanols.
What is the toxic gas produced by vaping?
It has been proposed that vaping induced pyrolysis of vitamin E acetate may produce a highly toxic gas called ketene. 12 Inhalation of ketene can cause severe lung damage in low concentrations and death in high concentrations. 13.
How does vaping affect public health?
Concerns over the impacts of vaping on public health have been steadily growing over the last decade. However, it wasn’t until August 2019 when the issue took center stage as the first vaping-linked death was reported in Illinois. This would be the first of many deaths that would ultimately be linked to an outbreak of a vaping related illness that the CDC has termed EVALI (electronic-cigarette, or vaping, product use-associated lung injury). 1 This may not come as too much of a surprise as vaping related illnesses have been reported for years. 2 But this is something different. EVALI isn’t simply an adverse health effect from vaping. It’s an acute lung illness that has spread rapidly across the country, affecting mostly young adults with a median age of 24 years old. 3
How many deaths from vaping in 2020?
3. As of January 7, 2020 there have been 2,602 cases and 57 deaths linked to EVALI in the U.S. and surrounding territories.
Can vitamin E cause lung damage?
In fact, some experts argue that it’s unlikely vitamin E acetate alone could cause the severe lung damage associated with EVALI. 11 The question of vitamin E acetate toxicity may be linked to the vaping device itself.
Is evali a form of PS?
Still, the EVALI mystery may be more complex than disruption of PS alone. Though initial reports presented EVALI as a form of lipoid pneumonia, later studies of EVALI patient lung scans showed signs that were more consistent with inhalation of toxic chemicals. In fact, some experts argue that it’s unlikely vitamin E acetate alone could cause the severe lung damage associated with EVALI. 11 The question of vitamin E acetate toxicity may be linked to the vaping device itself. Experts argue the high temperatures achieved by vaping and e-cigarette devices serve as a catalyst for unpredictable chemistries in the vaping mixture. Such temperatures would lead to pyrolysis, or thermal decomposition, of molecules into potentially more hazardous chemicals. In fact, scientists suggest vaping devices can be considered crude and uncontrollable mini-pyrolysis devices which are being used to inhale decomposed chemical compounds from unknown mixtures. It has been proposed that vaping induced pyrolysis of vitamin E acetate may produce a highly toxic gas called ketene. 12 Inhalation of ketene can cause severe lung damage in low concentrations and death in high concentrations. 13
Does vitamin E affect lungs?
Vitamin E acetate and your lungs. One of the proposed mechanisms for EVALI associated lung damage is the potential interaction of vitamin E with pulmonary surfactant (PS) in your lungs. PS is a phospholipid layer that lines the tiny air sacs in your lungs. These air sacs, known as alveoli, allow your bloodstream to exchange carbon dioxide ...
Introduction
E-cigarettes or vaping products are battery-powered, alternative nicotine delivery systems that vaporize a formulation of vaping liquid or e-liquid. The liquids most commonly contain carrier solvents, propylene glycol (PG) and/or vegetable glycerine (VG), nicotine and flavours.
Materials and Methods
99.7% pure propylene glycol and 99.2% pure glycerol were purchased from Sigma-Aldrich (Oakville, Canada). HPLC grade methanol, acetonitrile and hexane were purchased from Fisher Scientific (Ottawa, Canada). Vitamin E acetate (D, L-α-Tocopherol acetate) (≥99%) analytical standard was purchased from Sigma-Aldrich (Oakville, Canada).
Results and Discussion
During the development of the targeted method matrix effects were observed due to the presence of carrier solvents PG and VG, Figure 1.
Conclusion
In our study, Vitamin E Acetate was not detected above detection limit (0.159 µg/mL) in any nicotine containing vaping liquids analyzed. Two diluents of concern-Vitamin E Acetate and medium chain triglycerides, were analyzed as pure substances in order to better characterize their emissions.
Data Availability Statement
The original contributions presented in the study are included in the article/ Supplementary Material, further inquiries can be directed to the corresponding author.
Author Contributions
IK conceived, designed and performed the chemical analysis, supervised data processing and wrote the manuscript. CK supervised the targeted analysis of vitamin E acetate and reviewed the manuscript. GK performed the chemical analysis and revised the manuscript. DP generated the emissions, performed the analysis and revised the manuscript.
Conflict of Interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
What is vitamin E acetate?
Vitamin E acetate is used as an additive, most notably in THC-containing e-cigarette, or vaping, products. Vitamin E is a vitamin found in many foods, including vegetable oils, cereals, meat, fruits, and vegetables. It is also available as a dietary supplement and in many cosmetic products, like skin creams.
What is an e-cigarette?
Using an e-cigarette is commonly called vaping. E-cigarettes work by heating a liquid to produce an aerosol that users inhale into their lungs.
How many deaths from evali in 2020?
As of February 18, 2020, a total of 2,807 hospitalized EVALI cases or deaths have been reported to CDC from all 50 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands). Sixty-eight deaths have been confirmed in 29 states and the District of Columbia (as of February 18, 2020).
How to contact CDC about e-cigarettes?
If you have questions about CDC’s investigation into the lung injuries associated with use of e-cigarette, or vaping, products, contact CDC-INFO or call 1-800-232-4636.
Is vitamin E acetate linked to the eli outbreak?
Vitamin E acetate is strongly linked to the EVALI outbreak. Vitamin E acetate has been found in product samples tested by FDA and state laboratories and in patient lung fluid samples tested by CDC from geographically diverse states. Vitamin E acetate has not been found in the lung fluid of people that do not have EVALI.
When is the next vaping hospital admission?
Dates of symptom onset and hospital admission for patients with lung injury associated with e-cigarette use, or vaping — United States, March 31, 2019–February 15, 2020. Numbers do not sum to 2,807 due to missing admission dates.
When will vaping peak?
Emergency department (ED) visits related to e-cigarette, or vaping, products continue to decline, after sharply increasing in August 2019 and peaking in September.
How many people died from vaping?
As has been the case for months, the vast majority of patients reported vaping THC. As it stands, there have been more than 2,000 cases of lung illnesses and 39 deaths associated with vaping. The most common factor among those who have fallen ill over the past three months is that they vaped black market THC products, often bought off the street or from friends. Unfortunately, the CDC has been consistently ambiguous on the question of whether or not commercially available e-cigarettes containing nicotine are responsible for the outbreak. It is clear they are not responsible.
Is the CDC ambiguous on nicotine?
And he is right, the CDC’s ambiguity on the nicotine did not go unnoticed. Groups dedicated to the prohibition of e-cigarettes seized on the recent tragic deaths to pressure FDA, Congress, and governors to crack down on vaping.
Can e-cigarettes cause lung injury?
But the CDC persisted in saying it couldn’t rule out regular e-cigarettes as a cause of the outbreak. As late as Nov. 1, the CDC advised: “because the specific compound or ingredient causing lung injury is not yet known, and while the investigation continues, persons should consider refraining from the use of all e-cigarette, or vaping, products.”
