*2024 Update - Now you can make the switch with the New SMOKO VAPE POD! A pre-filled pod-style vape using our UK-made e-liquids!
The cause has finally been found for why people in the US have become ill or even died from using e-liquids: a chemical called vitamin E acetate. This is a chemical added into e-liquid infused with THC (the psychoactive chemical of marijuana) to make it thicker, and is the cause of the outbreak according to the CDC.
VAPING IN THE USA
For those who don't remember, a couple of months prior to writing this article, the people in USA started falling ill and in some cases dying, with the only link between them being that they vaped. This led to a panic, with people declaring that all vaping was dangerous, and that they should ban it.
To make the panic worse was the fact that in the US they are currently having an issue with underage vaping, with huge e-cigarette brands seemingly considered "cool" and attracting teenagers. Though the marketing for these brands wasn't specifically targeting teenagers, they certainly were trying to target a younger demographic than most e-cigarette companies.
And if that wasn’t enough, recently in the USA there has been a flood of extremely cheap e-liquids being homemade, as the laws regarding what can be sold are more lax (depending on which state you buy them in), as well as “black market” items such as the e-liquids with THC added in which started this. These liquids were not regulated or measured in any way, meaning that they could contain any number of bad chemicals.
All this led to a widespread panic about the safety of e-cigarettes, the teenagers using them, and e-liquids and vaping in general. It also raised the issue of whether e-cigarettes act as a gateway to smoking. The American media jumped onto this and soon President Trump announced that he was banning any e-liquid flavour which wasn't tobacco.
This is not to downplay the seriousness of the issue, after all with new cases still appearing (though the rate has slowed to a trickle now) the number of people affected has reached over 2000.
It is great news that the CDC has found what was causing this, and hopefully will now take steps to stop this from happening again.
VITAMIN E ACETATE IN E-LIQUIDS
The chemical responsible, vitamin E acetate, was never meant to be included in e-cigarettes, and was added into e-liquids to help the THC vaporise better. This is of course illegal as THC is a banned substance, but that didn't stop thousands of people from buying it.
The investigators at the CDC said that 79% of those who were affected admitted to using these black-market e-liquids with THC in it. The remaining 21% haven't been explained yet, though it seems strange that these 21% have exactly the same symptoms as the rest but without the apparent cause.
In a separate study to find the cause of this illness, health inspectors in the state of Illinois surveyed over 4000 e-liquid users and found that those who got ill were much more likely to use e-liquids with THC in, and were 9 times more likely to buy e-liquids on the street rather than from a reputable source.
The two theories at the moment which hold the most weight is that the 21% either bought e-liquid not knowing that it had vitamin E acetate in it (which would have to be from a grey market source, as even in the USA this chemical wouldn't be allowed in any legal e-liquid), or they don't want to admit they have been using THC.
This whole incident showcased two issues that need to be addressed by the US e-cigarette industry, the number of teenagers using e-liquids, and the black or grey market of e-liquid.
The black market is of course the worst offender here, offering THC infused e-liquids which are not only illegal but untested. The grey market holds a lot of the blame too, although the e-liquids sold there don't contain chemicals that are illegal they could literally contain anything else. You don't exactly get the most rigorous testing from people who have mixed their e-liquid in a bathtub after all.
DIACETYL AND POPCORN LUNG
Another scary condition that is linked to vaping (by the media) is 'popcorn lung'. The proper name being bronchiolitis obliterans, it is a condition that causes scarring in the lungs, leading to hardening of the tissue and restricting the flow of air. This condition has been linked to a flavouring, diacetyl, and is named for the first instance where the condition arose - in popcorn factories using diacetyl to flavour the popcorn.
The media articles highlighting this as a danger for vapers are often inaccurate, claiming that vaping alone is associated with popcorn lung, when it is actually linked to diacetyl. In the UK and EU, where we have good levels of regulation, diacetyl is banned from inclusion in e-liquids. However, e-liquids produced where regulation is thin or non-existent, could possibly contain diacetyl.
WHERE TO BUY THE SAFEST E-LIQUIDS
If you're a UK or EU reader the good news is that the issues surrounding the US aren't happening here. Due to the laws passed in 2016 (the Tobacco Products Directive) all e-liquids have to be tested by a 3rd party and pass rigorous examination before they are allowed to be sold.
The TPD law addressed the issues that the USA is facing now with underage e-cigarette users and untested e-liquid. Firstly, they made it illegal for anyone under the age of 18 to buy e-liquids, as you might have noticed when you entered this website or whenever you make an order. It also stopped e-cigarette companies from marketing to just anyone.
And the good news is that is seems to be working, Public Health England (PHE) conducted a study of teenagers early this year and found only 0.2% of teenagers who don’t smoke use an e-cigarette. While it would be better if this was 0% it does show that the new rules are working. To see how effective these laws have been all you have to do is compare the UK’s percentage to the USA where 27.5% of teenagers have used an e-cigarette in the last 30 days.
These laws also made it illegal to sell any e-liquid that hadn't been tested for harmful chemicals (like vitamin E acetate), and required all e-liquids to be tested within a system to check for a consistent amount of nicotine in the vapour produced as well (to make sure the heating of the e-liquid didn't change anything).
If the e-liquids with vitamin E acetate were tested in the UK they would never have passed the testing.
That’s why here at SMOKO we not only have our e-liquids tested, but made in the UK as well, that way we can make sure that we know exactly what is in our e-liquids and that is all our ingredients are pharmaceutical-grade.
But if you are still worried there are two pieces of advice that can help:
1) Make sure that any liquid you buy is tested and is preferably made with only the highest quality ingredients. That's why here at SMOKO we make sure all our liquids used in our E-Cigarettes are made in the UK, that way we cannot only make sure that they are tested to the highest grades but also all the actual ingredients are pharmaceutical grade.
2) Use a closed system instead of just e-liquids. If you are not sure where your e-liquids are coming from or how they will react to your battery's voltage (as e-liquids can change depending on how they are heated) then choose a system that has been tested with the e-liquids inside to make sure the vapour produced holds nothing more than it needs.
At SMOKO, our e-liquids are made in the UK and are subject to the Tobacco Products Directive regulations, meaning that the e-liquids in our E-Cigarettes are free from chemicals like vitamin E acetate, diacetyl and other chemicals known to be harmful when inhaled.
*2022 Update - Now you can get a FREE E-Cigarette starter kit when you buy a box of SMOKO E-Cigarette refills! *(Cigalike starter kit, one per customer)