CDC’s vape probe yields prime suspect for lung damage

An additive called vitamin E acetate has emerged as the frontrunner for the agent that is causing serious lung damage in people using e-cigarettes or vapes.

The Centers for Diseases Control and Prevention (CDC) said that testing of samples of fluid collected from the lungs from 29 patients who developed acute lung injury after using vape products found vitamin E acetate – also known as tocopheryl acetate – in all of them.

“This is the first time that we have detected a potential chemical of concern in biologic samples from patients with these lung injuries,” said the agency in a statement, adding that it had tested the bronchoalveolar lavage (BAL) fluid for a range of other chemicals that might be found in e-cigarette, or vaping, products, including plant oils, petroleum distillates like mineral oil, MCT oil, and terpenes.

Tetrahydrocannabidiol (THC) – the main psychoactive component of cannabis – was found in 82% of samples, while nicotine was found in almost two thirds (62%).

CDC stresses that while it appears that vitamin E acetate is associated with the lung reactions, “evidence is not yet sufficient to rule out contribution of other chemicals of concern,” although at least one state (Ohio) has already banned the use of the compound in medical cannabis products.

At last count on November 5, there were 2,051 cases of lung injury linked to vapes across 49 US states – all except Alaska – and 39 confirmed deaths. Until the investigation is complete, the CDC has urged the public not to vape any product, and in particular to avoid those containing THC.

Former FDA Commissioner Scott Gottlieb has previously suggested the most likely culprit was likely to be illicit and counterfeit vape products, particularly those used to deliver THC which are only legal in some states.