CDC Confirms a THC Additive, Vitamin E Acetate, Is Culprit in Most Vaping Deaths
npr.org
npr.org
The cause behind recent fear mongering over vaping is pure and simple. Some jurisdictions have become dependent on the revenue from the vice tax on tobacco and have seen vaping slashing their income more and more each year. Vaping must be made out to be dangerous so there is an excuse to tax and regulate it just like tobacco.
In any case, reasonable regulations are already going into place in states where THC products are legal: https://www.bostonmagazine.com/news/2019/12/12/thc-vape-mass...
The availability of known-safe, conveniently-available, regulated alternatives tends to erode black markets pretty successfully. See alcohol or Spotify as examples.
Then from your second link regarding new regulations:
...the CCC said it has not seen evidence that anyone stricken with the mysterious and in some cases deadly lung condition bought their vape products from a licensed pot shop or medical dispensary. They are instead believed to have been sourced from the black market.
It shouldn’t even make the top 1,000 list of things to bother worrying about.
That’s the interesting part of the article.
> It was important to understand the timing of the outbreak as part of this investigation. Health officials wanted to know when exactly the problems first cropped up, and whether they had missed many cases before those initial reports. That's why they turned to the surveillance data, collected from more than 3,200 emergency rooms from most states.
>They found a gradual increase in emergency-room visits among people who vaped or used e-cigarettes, starting in January of 2017.
> The surveillance system doesn't automatically flag health concerns – often scientists dive into the data once their suspicion is raised, as it was in this case. The outbreak only became apparent in the data once researchers defined more closely what they were looking for and focused on one age group.
I'd be surprised if there wasn't some kind of outlier detection method that could automatically flag a sudden increase in unusual cases.
But for stuff like this that isn’t a defined syndrome and isn’t really captured well at the hospital it’s not an outlier until scientists do a lot of analysis.
It would be cool, but seems kind of impossible to tell a significant outlier (vape lung) from an insignificant outlier (misspelling).
The way the article describes it, epidemiologists define a new condition (vape lung) and then look for that.
[0] https://www.cdc.gov/nssp/documents/guides/syndrsurvmessaggui...
Is there are another reason why it seems institutions are so resistant to this? They seem more concerned with raising the age to buy these products to 21 worldwide.
https://www.nytimes.com/2019/12/19/health/cigarette-sales-ag...
& then also, I suspect the incumbent tobacco industry lobbying effort is already deeply entrenched and dwarfs anything that might be fielded by the e-cig industry.
Further, alcohol has a drinking age of 21 making it somewhat harder for young teens to regularly access. Vaping on the other hand becomes a regular habit due to easy access.
Imagine UBL saying he was going to "infect" America with an addictive carcinogen. There would be true outrage. But since we do it to ourselves - fed approved - it normal.
I don't know what the real number is. There are plenty of studies showing it's negative, mostly funded by tobacco companies. That might not quite be true, but it's not far off: a non-smoker who lives to 90 has similar levels of health issues in his last 5 years as a smoker who dies at 65.
Reducing smoking would be a huge public good, but the benefit mostly accrues to the smoker, not to the state. We don't need to pretend it's otherwise for these campaigns to make sense.
You’re making GP’s point. If you filter for just tobacco users from the general population it could very well be above a million per tobacco user.
It turns out smokers do cost more while alive, but die sooner which mostly erases the difference in medical costs. There are estimates for lost productivity amounting to 150 Billion per year in the US, but again these ignore the fact Nicotine is a stimulant.
Clearly the living have higher medical costs than the dead so some indirect savings exist. Thus, net costs are below that 170B and thus wildly off of a 500B net healthcare cost.
$5T would be "wildly off"...
And you must concede that even "only" a $170B reduction in medical costs could change the entire market.
It may cost 20$ to eat out at lunch, but the alternative is not skipping eating. So the net cost for eating out is the delta between my options.
Random study: Results Smoking was associated with a greater mean annual healthcare cost of €1600 per living individual during follow-up. However, due to a shorter lifespan of 8.6 years, smokers’ mean total healthcare costs during the entire study period were actually €4700 lower than for non-smokers. For the same reason, each smoker missed 7.3 years (€126 850) of pension. https://bmjopen.bmj.com/content/2/6/e001678.
I would be surprised if the stimulating effects outstripped the dying early effects.
edit: just did a brief search and apparently on aggregate former smokers who quit have increased productivity following quitting, so even while smoking there is decreased productivity effects
Remove cigs, replace them with vapes. Presumably the effect is the same, but the vapers live slightly longer than they would've if they were smokers.
I don’t want to defend cigarettes which are I feel are very much a bad thing. However, I object to people misusing statistics and generally deceptive practices.
Cigarettes are bad because they kill people and cause direct suffering. The relative impact to your taxes and national GDP are irrelevant by comparison.
I agree that we should be honest with the stats, which is why I think it was disingenuous to claim that $500 billion was wildly off when the reported costs from the CDC were a substantial portion of that. Sure, we can start considering secondary effects like cost savings from people dying early and productivity lost, etc. etc. But all I'm saying is that I don't think the original claim was on its face absurd.
Agreed that we shouldn't be doing some absurd cost-benefit analysis for the economy when considering whether to combat smoking, obviously people dying is sort of a priori bad.
Also, if you object to wildly off base that’s fair. I would call even the 3x difference between the CDC’s 170B and my simplified 500B sanity check as wildly off base. But, that’s just my scale +/- 50% is fine, 2x raises read flags for me, but out at 3+x is a fundamental incompatibility in different estimates.
Considering how most vape products seem to be made on a shoestring in some factory in China, I think CDC and the FDA should be throwing enormous amounts of money into building high quality, super effective vape products.
And nicotine has this weird reputation as being dangerous, but beyond addictiveness it has not be shown to be harmful, even potentially neuroprotective. Not to mention scaremongers tend to ignore that it is a stimulant, and can help with anxiety. Schizos are known to self medicate with it, for example.
Agreed that is a completely different problem than smoking, but still worth discussing since it is so addictive.
What i often seen is the number of teens who have vaped in the last year compared to habitual smokers
Do you know how long smoking was around before we had actual evidence that it was harmful?
(Hint: The rough order of magnitude of the time is centuries.)
Case studies can't spot harm faster than the harm occurs. The main harm from smoking is a significantly increased risk of lung cancer and other illnesses which can take decades to show up. That's why even with modern medicine advancing over the last century it took so long to nail down the health risks of smoking.
I used to smoke, and now I vape. My lungs function so much better now that it’s easily discernible to me that smoking irritates lungs far more than vaping.
Modern laboratory science is no help in figuring out fast whether vaping is harmful, because we don't understand how the human body works well enough to do laboratory tests that will tell us. So we're reduced to basically what we used to show that smoking was harmful: long-term data collection and analysis.
> My lungs function so much better now that it’s easily discernible to me that smoking irritates lungs far more than vaping.
Saying that vaping is less harmful than smoking (which is probably true) is a much weaker statement than saying that there's zero indication that vaping is harmful, so there's no reason to worry about it, which is the claim I was responding to.
Now, you could argue that there's little evidence of nicotine being harmful aside from being highly addictive (although even then there would be an economic argument to be made), but if there is any harm, the addictive nature will make sure that harm is long-lasting.
Yeah, but your source also says that vaping rates are up, outstripping any decreases in smoking rates.
>It showed that 27.5% of high schoolers had vaped in the past 30 days in 2019, up from 20.8% the year before. Meanwhile, teen cigarette-smoking rates dropped from 8.1% to 5.8% in the same time period.
This seems to support what the parent post is saying:
> E.g. instead of fewer people having very expensive cancer care, vaping could still cause some damage and incur costs across more people.
I can't tell if media is ruining society or if society has ruined media.
I suppose you could make a case that it's not that bad, or that it'll not happen again, or that patrons of brightly-lit stores have lower risks.
Instead, you're making a case that this proves the safety of all vaping products not tainted with this specific ingredient. That was not very convincing.
I certainly don't.
https://www.state.nj.us/dobi/division_insurance/ihcseh/ihcra...
And insurance is just insurance. out of pocket maximum is usually $10k+, so if you do need care, add that to premiums.
Like I could see something happening in a year, but not every year.
If one in 10 people is over 70 and some others get serious or chronic illnesses earlier in life, the mean cost per person could easily be much higher than the median cost per person.
The mean can be calculated from the total: just divide by the population. That’s what the commenter to whom you replied did. The total was probably easy to estimate, as the largest healthcare providers’ revenues are in their public filings.
Calculating the median requires individual data. That is much harder to get because, in many cases, no one except the patient has the data.
And then I had an operation this year (unrelated to the diabetes.... kind of), so that adds another 10,000$, give or take.
So yeah, I break 10k (for a family) before anyone even gets to visit a doc. Where they slap you with extra $$$ on anything.
We should mandate that everyone has to pay for their own health insurance (e.g. healthcare). Put a full stop on employer provided health plans. And have people actually pay from their hard earned $ to the health providers for the right to show up. Now for a lot of people who get benefits through employment, the absurdity of the cost isn’t visible enough to actually care / do something about the situation.
$832.21 X 12 -> $9986.52
Smokers (and the obese) are cheaper in health care costs than non-smokers. Why? To be blunt, because smokers die early.
Keeping someone alive into their 90s is more expensive than someone who dies of smoking derived illness in their 70s or younger. This is similarly true for the obese.
But this isn't an argument we accept in public health. If it was, we wouldn't provide any healthcare that prolonged life after someone was after working age.
Regardless there are still an awful lot of really dibilating conditions that massively affect productivity caused be tobacco related illnesses that isn't just death or cancer care.
It may well be a cost worth paying. I’m not arguing policy. OP’s math made incorrect assumptions. Just letting them know.
The use less. But they also are able to contribute less.
That said, yes a whole lotta money is spent on the last 0 to 6 months (or so) of life. From what I understand, this is a USA only problem.
The study I linked was based on the Netherlands. I suspect the cost difference will be true for most countries. Unless you just let people die earlier. But that’s a whole other discussion.
I don’t know if anyone has done any studies on productivity differences. That would be interesting.
The laws should be taken off the books. It's cheaper to not have the bad decision makers around. (anti Idiocracy)
Disclosure, I ride a MC every day.
They don’t call them donorcycles for nothing.
It is maybe dated a bit now. I think it refers to boomers (in the 90s/00s?) rather than modern riders. But still awkwardly accurate.
They are more of a burden to society than smokers.
In purely financial terms, it's negative; premature deaths from tobacco (even with the health care costs of tobacco-related disease) actually significantly reduce health and net social welfare costs.
The benefit is in years and quality of life (mostly in the after-working-career years), not financial returns.
The problem is that vaping is converting non-smokers into vapers. That's a really BAD ROI.
Estimates are now as high as 25% of high schoolers vape and has snagged more women than cigarettes would have. That's undone 20+ years of anti-smoking efforts. So, yeah, public health officials are really pissed off.
Yes, vaping is a good replacement for smoking. It's not a good replacement for not smoking, however.
[1] https://www.webmd.com/smoking-cessation/news/20021023/harnes... [2] https://www.sciencemag.org/news/2011/06/why-smokers-are-skin...
I agree that the "nicbacco" mindset is fallacious and not well-reasoned, but also that while vaping is significantly better than smoking, it's not better than not vaping.
For adults who want to derive the benefits historically gained through tobacco use without incurring the full extent of the damages, certain types of vaping aren't a poor method.
So it would be rather silly for the WHO to invest billions in moving people from one ”tobacco” industry to another at this point.
Even if we assume it’s safe, I’m not sure your suggestion is really sound. There is no evidence suggesting that smokers are actually that expensive to a society. Yes, they tax the healthcare system making up as much as 70-80% of the total expenses in some countries, but they also live shorter. There isn’t actual science on this, because it’s highly immoral, but the biggest expense of a lot of western countries isn’t healthcare, it’s elderly care, and that’s an area that benefits greatly if you die in your seventies after a relatively short period of lung cancer as smokers are prone to do.
It certainly helps with the smell, the basic side products of burning, and so on, no?
Sure that might not mean much in terms of total impact on QALYs. (Because it might lead to prolonged exposure of lower dosages, ultimately resulting in the same grave health impact.)
> Further research focused on vitamin E acetate, which is used in some of these preparations to dilute the much more expensive THC oil.
“vitamin E acetate, is a synthetic form of vitamin E. It is the ester of acetic acid and α-tocopherol” (Wikipedia)
https://en.wikipedia.org/wiki/Acetic_acid https://efsa.onlinelibrary.wiley.com/doi/abs/10.2903/j.efsa.... - "The substance readily hydrolyses" https://en.wikipedia.org/wiki/Lipid_pneumonia
A bit of an understatement, considering literal lead found in ganja (albeit rarely), any kind of dirt in hash, common use of amphetamines instead of psychedelics, and afaik some pretty deadly drugs instead of ‘regular’ opioids. And, I guess, antifreeze in wine if that's not a myth.
On one hand, a dead junkie doesn't buy junk anymore. On the other, the choice is often between selling something today or selling nothing, and apparently the short-term view wins.
If marijuana products are regulated like supplements are today, there's really no reason why less than scrupulous vape cartridge manufacturers wouldn't do exactly what they're doing today. There's no regulatory oversight when it comes to supplements.
The proper term for vitamin E acetate is “cutting agent.” Like talc in cocaine. Neither the original manufacturer nor the consumer wants it in there; it was effectively MITMed into the product.
A very precise analogy: you wouldn’t call cyanide a “Tylenol additive”, right?
It’s used to water down the product and sell more cartridges with the same amount of THC oil. The exact same thing cocaine dealers do with talc powder or some shady bars do watering down their bottles.
Taking a hit from a friends vape of unknown origin and substance still cool? Or is that insta KO
THC Distillate which is the base for most THC cartridges is made from any and all cannabis biomass or 'leftovers' from other processes. Since it's a highly pure (~94%) extraction, in terms of cannabis extracts, there is no worry about the starting products' quality/looks/smell as is the case with most cannabis products. All this results in this high-purity substance being much cheaper, and very high value for the customer.
The legitimate cannabis industry has dabbled with other diluents though (such as PG/PEG/VG and most commonly terpenes), mostly to help the very viscous THC distillate work with the cartridge hardware. However, nowadays, cartridge technology has improved so much that it is possible to use very viscous THC distillate in most cartridges. These legit vendors have known about various issues related to health concerns, due to health-savvy cannabis users. PG/PEG/VG are almost completely phased out for terpenes, which are currently seen as the better alternative (compared to PG/PEG/VG, not that it's safe). I've never come across legal cannabis vendors discussing Vitamin E as a dilutant in my research.
Warning: both ephedrine and guaifenesin increase blood pressure, so take care if that might be of concern.
Yes, fexofenadine is great (for me at least)
Beyond pesticides, I'm also generally skeptical of some of the solvents used for extraction. Supercritical CO2 extraction should be perfectly fine, but apparently not every brand is using that.
Vaping is definitely safer if implemented ideally, but it looks like the ultra-portable solutions are mostly still pretty sketchy.
You might be thinking of solder which is easily melted by resistive heating. But that is because its alloyed with Tin and the combination has a much lower melting point than either metals.
I get the impression this style of vape has started to go out of style though. Which is a shame because it's much more efficient than smoking, particularly if you save the toasted weed to make edibles with (extraction using food-grade coconut oil, butter, etc in your kitchen is very easy, or since it's already toasted you can even consume it without any processing.)
This is like how people gossiped about Boeing management for years before the 737-MAX finally demonstrated the consequences.
Or how people have smothered their doubts about the President because the market has been going up.