Summary
The Department of health evaluated 46 ThC-containing products submitted by 12 EVaLI (E-cigarette or Vaping product use associated Lung Injury) patients, finding that 52% of the products contained vitamin E acetate (VEa), 43% contained MCTs (medium-chain triglycerides), 43% contained CBD (cannabidiol), and 37% contained alpha-tocopherol (vitamin E). Vitamin E acetate was identified as a likely cause of EVaLI by the CDC in 2020, as it was found in most EVaLI patients' samples. a flavoring ban was instituted in January 2020 to prevent adolescent usage, but it only applied to pod-based products, and the FDa did not restrict or dictate the use of chemicals in e-liquid formulations.
Cannabinoids, including CBD and ThC, have been identified and quantitated in several products evaluated in this study, with concentrations as high as 332.6 and 497.7 mg/ml, respectively. Cannabinoid-based e-liquid formulations have existed since the advent of the modern e-cigarette. Nicotine e-liquids in pod-style products, which are more specifically regulated, have tended toward more simple compositions. however, nicotine salts used in JUUL liquid formulations have been observed to contain high levels of nicotine, which correlates with concentrations identified in other studies.
In summary, the FDa's regulatory language does not restrict or dictate the use of chemicals in e-liquid formulations, and vitamin E acetate has been identified as a likely cause of EVaLI. Cannabinoids, including CBD and ThC, have been identified in e-liquid products, and nicotine salts used in JUUL liquid formulations have been observed to contain high levels of nicotine.
Citation
holt aK, Poklis JL, Peace MR. a Retrospective analysis of Chemical Constituents in Regulated and Unregulated E-Cigarette Liquids. Frontiers in chemistry. 2021;9:752342. doi:10.3389/fchem.2021.752342
