The long growing vape crisis has reached a tipping point. The Centers for Disease Control & Prevention commented this past week on the growing outbreak of vaping-related lung diseases. While the argument between the dangers of smoking versus vaping rages on, the dangers relating to vaping seem to be more acute. This is especially true when considering black market vaporizers with unknown processing chemicals and contaminants. From the CDC, the number of cases confirmed or probable for the disease has risen from 530 to 805, an increase of 52% over the previous week . The growing outbreak has caused the death of a dozen people across 10 states, and cites the first major health related issue for the growing cannabis industry. While the cases are varied between the use of nicotine e-cigarettes, THC-containing e-cigarettes, and some combination therein, many point to the illegal cannabis market and bad manufacturing practices for the epidemic .
This crisis is raising public awareness related to the size and dangers of the illicit market. David Abernathy of Arcview Market Research noted that while the legal cannabis market in California is the biggest in the world, the illegal market is three times as big . Additionally, the black market products are, of course, completely untested for any of the contaminants specified by regulating authorities as potential public health concerns. Most notable is the abundance of cheap vape cartridges arriving from Chinese factories . A recent preliminary study performed by Afia, Weltman, and Boyar has begun researching the effects of these low-quality cartridges on concentrates over time. In most state-legal cannabis markets, all products must be tested for the presence of heavy metals such as Lead, Mercury, Cadmium, and Arsenic. In addition to black market concerns over cheap cartridges, Afia, Weltman, and Boyar also studied tested, state-legal products for evidence of heavy metal leaching. The concern is that products which previously tested clean from any and all heavy metals will experience a leaching effect on the shelves, with heavy metals in the cartridge transferring into the vape pens and finally being aerosolized into the consumed vapor. In their study, Afia, Weltman, and Boyar’s data suggests “that heavy metals do indeed leach from the hardware” and that a “significant portion of these metals end up in the condensate captured” . It is noted that more research is needed to fully understand the degree to which the cartridge is responsible for leaching effects.
As if the above concerns weren’t sufficient, the problem doesn’t stop there. NBC News commissioned one of the leading labs in the nation, CannaSafe (located in Los Angeles, California) to test a sampling of legal and illegal vapes for a number of contaminants. As expected, all vapes purchased legally were found to be clean of all toxins, including heavy metals, pesticides, residual solvents, and Vitamin E. However, 13 out of the other 15 samples from black market THC cartridges were found to contain Vitamin E . While the CDC and experts have not been able to link all of the cases to a single chemical, many state health officials have pointed at Vitamin E acetate as a potential culprit . From NBC News’ inspection, 10 illegal vapes were tested for illicit pesticides and all 10 tested positive. Additionally, these vapes all contained mycobutanil, which is a fungicide that has the potential to transform into hydrogen cyanide upon combustion .
While the issue seems to stem primarily from illicit THC vapes, states have also begun taking extreme measures to pull flavored e-cigarettes off the shelves and out of the hands of consumers. Michigan became the first state to ban flavored e-cigarettes, with New York quickly following suit. San Francisco was the first city to prohibit their sale as well. Recently, Massachusetts placed a 4-month moratorium on the purchase of all vaping products as well. While scrutiny has been placed on all vaping products, the CDC has specifically warned against both vaping products off the street, and adding substances not intended by the manufacturer. It is noted that the Secretary of Health and Human Services, Alex Azar, has said that President Trump is currently preparing a nationwide ban on flavored e-cigarettes .
On Thursday, California joined the list of public officials and government agencies across the US urging its citizens to stop vaping tobacco and cannabis products. The California Department of Public Health (CDPH) states that 90 Californians have been hospitalized and 2 have died from vaping related illnesses . Governor Gavin Newsome signed an executive order on September 16th to accomplish the following :
- Spend $20MM on a new public awareness campaign regarding the potential dangers of vaping both tobacco and marijuana
- Ask for recommendations on mandating additional warning signs on vaping products packaging and at retail locations
- Ramp up enforcement against counterfeit e-cigarettes and cannabis products 
Cannabis companies and manufacturers have spoken out against blanket statements regarding the safety of all vape products. For instance, the California Cannabis Manufacturers Association (CCMA) stated that the CDPH’s approach may further affect public health by eliminating good manufacturers of clean, safe products along with the low-quality vaporizers responsible for the epidemic . This echoes the study from NBC News, which found no contaminants in any of the legal products tested.
On September 24th, the CDPH released their report and health advisory regarding vaping and its risks, “no matter the substance or the source”. The CDPH also seemingly heeded CCMA’s advice, and warned about buying vaping products from unlicensed dispensaries who do not test their cannabis products prior to sale, and are much more susceptible to impurities .
On Thursday, September 26th, the Governor of New York, Andrew Cuomo issued a statement urging the Northeast states to work together to draft future recreational cannabis policies and refining of vaping regulations. The goal is to have the Northeast create a level playing field for the growing cannabis industry, with the development of a coordinated approach to vaping concerns a secondary objective .
The question remains on how to distinguish the good vape manufacturers from the poor vape manufacturers, and how to address the concern of additives which may not be safe for consumption via vaping. According to an article on MJBiz, manufacturers are turning to security labels, barcodes, and micro chips to help differentiate their products from the counterfeit knockoffs thought to be the reason for the current epidemic .
As the first major hurdle for the nascent cannabis industry, the vaping crisis is sure to bring significant changes in the manufacturing and testing of these cartridges. Once the responsible chemicals and contaminants have been identified, it is possible that the testing regulations will be changed accordingly. Additionally, it is possible that hardware tests as described by Afia, Weltman, and Boyar become mandatory to check for additional points of contamination. Ultimately, this crisis proves the need for testing and transitioning to the legal market. Untested products are widely thought to be responsible for this epidemic, and it is unfortunate that these products are damaging the legal industry. More to come as the situation progresses.
Written by Dan Brown, vice president, Rhine Laboratories
Afia, Ini & Weltman, Robert & Boyar, Kyle. (2019). Heavy Metal Contaminants from Cannabis Vaporizer Cartridges: Valid Concern or Blowing Smoke?.
“California Health Officials Urge Residents to Stop Vaping All Substances.” Marijuana Business Daily, 30 Sept. 2019, mjbizdaily.com/california-health-officials-urge-residents-to-stop-vaping-tobacco-marijuana/.
Egel, Corey. “California Department of Public Health Issues Public Health Advisory Urging Everyone to Refrain from Vaping.” California Department of Public Health, 24 Sept. 2019, mjbizdaily.com/wp-content/uploads/2019/09/California-Department-of-Public-Health-Vaping-advisory.pdf.
Ferguson, Conor, et al. “Tests Show Bootleg Marijuana Vapes Tainted with Hydrogen Cyanide.” NBCNews.com, NBCUniversal News Group, 27 Sept. 2019, www.nbcnews.com/health/vaping/tests-show-bootleg-marijuana-vapes-tainted-hydrogen-cyanide-n1059356.
Jackson, Margaret. “Cannabis Vape Manufacturers Turn to Packaging, Other Measures to Distinguish Their Products from Counterfeit Merchandise.” Marijuana Business Daily, 26 Sept. 2019, mjbizdaily.com/cannabis-vape-manufacturers-turn-to-packaging-other-measures-to-distinguish-their-products-from-counterfeit-merchandise/.
Kuznia, Rob, and Lena Sun. “Potential Culprits in Mystery Lung Illnesses: Black-Market Vaping Products.” The Washington Post, WP Company, 25 Sept. 2019, www.washingtonpost.com/health/potential-culprits-in-mystery-lung-illnesses-black-market-vaping-products/2019/09/24/cb5b708e-d98d-11e9-ac63-3016711543fe_story.html.
Lovelace, Berkeley. “CDC Says Vaping Lung Cases Surge 52% in the Last Week to 805 with at Least 12 Deaths.” CNBC, CNBC, 26 Sept. 2019, www.cnbc.com/2019/09/26/cdc-says-vaping-lung-cases-surge-52percent-in-the-last-week-to-805-with-at-least-12-deaths.html.
“NY Gov. Cuomo Wants States to Work Together on Recreational Cannabis.” Marijuana Business Daily, 27 Sept. 2019, mjbizdaily.com/ny-governor-wants-northeast-region-to-work-together-on-recreational-marijuana-vaping/.
Schroyer, John. “California Governor Issues Executive Order on Vaping.” Marijuana Business Daily, 24 Sept. 2019, mjbizdaily.com/ca-governor-issues-executive-order-on-vaping-saying-its-an-e-cigarette-and-marijuana-problem/.