https://www.cdc.gov/mmwr/volumes/69/wr/mm6902e2.htm?s_cid=mm6902e2_e&deliveryName=USCDC_921-DM17160

Comment; As of January 7, 2020, among 1,979 patients with available data on substance use, 82% reported using any THC-containing products, while 13% reported exclusive nicotine-containing product use. THC was acquired “informally”, nicotine was commercially produced. So 13% of appropriately used vaping products harm lungs–a far lower amount than smoking tobacco. 82% of those using either THC alone or THC & nicotine had lung problems. Hmm, it’s not so much vaping, it’s the THC, vaping is still safer than smoking for nicotine use.

On January 14, 2020, this report was posted online as an MMWR Early Release.

Sascha Ellington, PhD1; Phillip P. Salvatore, PhD2,3; Jean Ko, PhD1; Melissa Danielson, MSPH4; Lindsay Kim, MD5; Alissa Cyrus, MPH6; Megan Wallace, PhD3,5; Amy Board, DrPH2,3; Vikram Krishnasamy, MD2; Brian A. King, PhD1; Dale Rose, PhD7; Christopher M. Jones, PharmD, DrPH2; Lori A. Pollack, MD1; Lung Injury Response Epidemiology/Surveillance Task Force (View author affiliations)View suggested citation

Summary

What is already known about this topic?

E-cigarette, or vaping, product use–associated lung injury (EVALI) patients in Illinois, Utah, and Wisconsin acquired tetrahydrocannabinol (THC)-containing products primarily from informal sources.

What is added by this report?

Nationwide, most EVALI patients with data on product source reported acquiring THC-containing products from only informal sources, whereas most nicotine-containing products were acquired from commercial sources. EVALI patients aged 13–17 years were more likely to acquire both THC- and nicotine-containing products from informal sources than were adults.

What are the implications for public health practice?

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.Article Metrics

CDC, the Food and Drug Administration (FDA), state and local health departments, and public health and clinical stakeholders continue to investigate a nationwide outbreak of e-cigarette, or vaping, product use–associated lung injury (EVALI) (1). EVALI patients in Illinois, Utah, and Wisconsin acquired tetrahydrocannabinol (THC)-containing products primarily from informal sources (2,3). This report updates demographic characteristics and self-reported sources of THC- and nicotine-containing e-cigarette, or vaping, products derived from EVALI patient data reported to CDC by state health departments. As of January 7, 2020, among 1,979 (76%) patients with available data on substance use, a total of 1,620 (82%) reported using any THC-containing products, including 665 (34%) who reported exclusive THC-containing product use. Use of any nicotine-containing products was reported by 1,128 (57%) patients, including 264 (13%) who reported exclusive nicotine-containing product use. Among 809 (50%) patients reporting data on the source of THC-containing products, 131 (16%) reported acquiring their products from only commercial sources (i.e., recreational dispensaries, medical dispensaries, or both; vape or smoke shops; stores; and pop-up shops), 627 (78%) from only informal sources (i.e., friends, family, in-person or online dealers, or other sources), and 51 (6%) from both types of sources. Among 613 (54%) EVALI patients reporting nicotine-containing product use with available data on product source, 421 (69%) reported acquiring their products from only commercial sources, 103 (17%) from only informal sources, and 89 (15%) from both types of sources. Adolescents aged 13–17 years were more likely to acquire both THC- and nicotine-containing products from informal sources than were persons in older age groups. The high prevalence of acquisition of THC-containing products from informal sources by EVALI patients reinforces CDC’s recommendation to not use e-cigarette, or vaping, products that contain THC, especially those acquired from informal sources. Although acquisition of nicotine-containing products through informal sources was not common overall, it was common among persons aged <18 years. 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.

Dr. Raymond Oenbrink
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