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I had a startup in Vaping(nicotine) and am still fairly in touch with the industry. There has been no major innovation in nicotine eliquid that would cause a su

I had a startup in Vaping(nicotine) and am still fairly in touch with the industry. There has been no major innovation in nicotine eliquid that would cause a sudden cluster of issues. It's stayed pretty constant since 2013 with the exception of Salt Nicotine, which Pax labs has a gras study published for. The majority of cases seems to be THC carts where it can be confirmed. One case was confirmed from a dispensary in Oregon. The "Dank Vapes" carts are sold on eBay/AliExpress and anyone can fill them with anything. Reading on here the VitE may have been to increase potency is not something I'm familiar with since I'm not in the TCH trade, but I do know that synthetic vitamin E is made from a petroleum product precursor, and a food grade level of purification may not mean a quality to which it should be vaporised and inhaled. CDC's reaction is over the top, especially next to the FDA which is offering more precise warnings of avoiding THC carts. Be safe if you're using these thc products, especially since even larger suppliers have trouble tracking supply, bank accounts and company formation that typically cleans up quite a bit of the bad actors from an industry. Nicotine vapes have matured significantly because of this moving to clean labs and central production of the liquid.

atlasunshrugged 7y ago
As someone who was in the industry, what do you think about the argument of vaping being a safer alternative? I see pretty mixed things in the health community but it's tough because some of the argument seems to be that the tobacco industry has acted nefariously in the past so we can't trust any innovation in the space. Is there any known experience similar to vaping/smoking of today that has really minimal health consequences but maybe isn't as addictive?
- rkangel 7y ago
  If you are an existing smoker and if your device and liquid are from a reputable supplier, absolutely yes. The problem is that a lot of the industry is not reputable and not well controlled. This means that you can get liquids that contain all sorts of things and devices that heat in an uncontrolled way. Even the perfect liquid if overheated (as it is in many large devices) produces aldehydes. As you might expect, breathing formaldehyde is bad. The industry also seems to be taking the opportunity to up the nicotine numbers, so if your intention is to give up that's not helping.
- johngrefe 7y ago
  I think it's a lot safer than smoking, there's probably a lot safer methods, but vapings efficacy vs other quit methods is just too good to discard for even slight health risks vs smoking. Only Juul/Pax has a hidden Big Tobacco interest, the rest are either overt or companies that are dedicated to vapor only. Almost all the innovation came from outside Big Tobacco, but all that is coming to an end with FDA'S regulations of Vaping. No new products so I left, since I exclusively designed hardware. Most vapor products can be used with eliquid that has varied levels of nicotine and most shops were (2012-2017) very active in promoting customers to reduce their nicotine level to 0, so addiction to the devices can be self regulated if that is your goal.
  - atlasunshrugged 7y ago
    Okay, didn't realize it was only Juul/Pax that had that hidden interest. I'm mainly in Eastern Europe these days and Philip Morris is pushing IQOS hard (I know it's in a different category but I think it eats at the same market share, younger more affluent health-conscious users who know cigs are bad but still want to smoke something) You mention there probably being safer methods - any idea on them or where I should look for more info? I've been researching tobacco, mainly taxation (which in theory is one of the most powerful ways to get people to quit things, by jacking up the prices) but I'm generally interested in the field, and it seems to me that a potentially even better methodology than making things too expensive for many to afford is to innovate and develop something that's just way healthier a replacement that gives consumers the same benefits.
    - rkangel 7y ago
      Yes, Juul was bought for $4bn by ALCS which is the parent company behind Philip Morris USA, Marlboro and many other brands. Philip Morris International (i.e. Europe) is technically a separate entity. They were separated out a while ago (probably to avoid anti-trust issues). In theory they share stuff with the US but the separation is why you're getting different products.
  - rkangel 7y ago
    Interestingly, one big manufacturer I worked with specifically avoided making their device a 'cessation aid' - something to help give up. You can think what you want about their motivation, but the explanation they gave is that if you are a cessation aid then you get into medical device territory and so hit a load of extra regulation.
- Reelin 7y ago
  > vaping being a safer alternative A safer alternative to what? Smoking cigarettes? There's absolutely no question that it is. One is a plant product (smoke is bad to inhale) that naturally contains a number chemicals that you probably don't want to be consuming. On top of this, there are additional additives (which vary by manufacturer) that also have significant health effects. Overview (https://en.wikipedia.org/wiki/List_of_additives_in_cigarettes https://en.wikipedia.org/wiki/List_of_additives_in_cigarette...) and more details (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2040350/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2040350/). The other is almost entirely a mixture of Propylene Glycol and Vegetable Glycerin. ...except when it isn't, as seems to be happening here. The safety of vaping is entirely dependent on what's in the liquid you're vaporizing; always keep that in mind when purchasing it. Also, do bear in mind that it's probably not fantastic for your health to be chronically inhaling anything other than highly purified air, no matter how benign it may seem. Relative to smoking cigarettes (or any other plant product), it's much safer. Relative to not vaping at all, there are likely to be at least some health risks, even if they haven't been clearly established yet. > Is there any known experience similar to vaping/smoking of today that has really minimal health consequences but maybe isn't as addictive? If you're asking about drugs with similar effects to nicotine that are less addictive, I'm not aware of any. You could always purchase vaping liquid that doesn't contain any nicotine though.
  - atlasunshrugged 7y ago
    Sorry, yes, safer alternative to smoking cigarettes Fair enough, I'm sure it's not healthy to chronically inhale anything other than air > If you're asking about drugs with similar effects to nicotine that are less addictive, I'm not aware of any. You could always purchase vaping liquid that doesn't contain any nicotine though. I was asking that but a broader question for me is, are there any safe replacements for cigarettes out there that match the qualities that cigarettes have without the harmful side effects (the idea being if you could create something that was just as fulfilling, addictive, etc. but without the negative side effects you could dramatically decrease the health toll of cigarette smoking). You could argue vapes are that product but it seems like the jury is still out on how much better they actually are than cigarettes and the trouble with attracting new users into the market
wil421 7y ago
My local news ran a segment about THC vapes. Some local doctors were talking about an increase in vape related hospital visits. They interviewed the guy and he basically said he bought a random THC vial from some guy who walked up to him on the street. He said it didn’t feel right and was probably spice or something synthetic. Be careful, YMMV.
fukbezos 7y ago
Is there any way to test carts for vitamin E? If not I think I've just identified a market ripe for the picking.
cptskippy 7y ago
In all my experience working for a non-profit that closely involves itself with the CDC and smoking related research, I would never describe the CDC's actions as over-the-top. They do all their own research and are very measured and even handed with their messaging. Contrast that to the FDA who have outsourced their job function to back to the companies they're supposed to be regulating.
- tdy_err 7y ago
  Three are and have always been three components of e-liquid: - propylene glycol (used in ice-cream soda etc) - vegetable glycerin - food flavoring Besides proportions changing the only other variant is the type of flavoring. It's not actually too complicated. And If one of those ingredients was suddenly tainted people using vaporizers would not be the only ones affected, of course.
  - zaphar 7y ago
    All three of those elements are not usually vaporized and then inhaled in large quantities. Extrapolation from their effects when ingested is unlikely to apply in these cases. Your conclusion does not follow from the evidence.
    - ad-hominem 7y ago
      propelene glycol is and has been used as an air santizer for a very long time. https://archive.epa.gov/pesticides/reregistration/web/pdf/propylene_glycol_red.pdf https://archive.epa.gov/pesticides/reregistration/web/pdf/pr...
      - cptskippy 7y ago
        In your document the Cat 4 exposure dose was stated to be 2.34 mg/L, a recent study[0] found that inhalation exposure at 0.442 mg/L resulted in slight irritation. What's the exposure when vaping? The document you link to actually avoids addressing Aggregate Exposure by stating there's insufficient information to draw any conclusions. > "Since toxicological endpoints for risk assessment were not identified based on the available data, an aggregate risk assessment was not conducted for propylene glycol and dipropylene glycol." Isn't Aggregate Exposure what we're concerned about with Vaping? Additionally these studies all talk about aeroslized or nebulized pg, vaporizers are thermal in nature. Does heating pg matter? The CDC is basically saying "We don't know what this shit does because no studies have ever exposed people to it in this manner. Until we know more you should probably not vape it". [0] Dalton P, Soreth B, Maute C, Novaleski C, and Banton M (2018). "Lack of respiratory and ocular effects following acute propylene glycol exposure in healthy humans". Inhal. Toxicol. 30: 124–132.
urbanjunkie 7y ago
LMFAO You: "I work in the vaping industry and i urge everyone to ignore the CDC's advice until I've exited" HN: "sounds reasonable, a millennial engineer must know more than the CDC. Have some upvotes"
Scoundreller 7y ago
VitE can be used as an antioxidant/preservative. VitC is too, but E is fat soluble.
_fullpint 7y ago
> While many of the patients, but not all, reported recent use of THC-containing products, some reported using both THC- and nicotine-containing products. A smaller group reported using nicotine only. That’s directly from the CDC. They should probably stop using the word e-cigarette especially due to the fact nobody using the THC vapes calls them that.
- JoeAltmaier 7y ago
  Curious linguistic detail: they need to use the word that people using THC vapes expect them to use for clear communications to occur. As a stuffy international organization, they'd be expected to use something that sounds like a technical term. Vs for instance, some slang or cool-kid term.
  - thedaemon 7y ago
    They are called "cartridges".
lonelappde 7y ago
Interesting consequence of the global supply chain (really, network). For every ingredient or process sourced from a different manufacturer or factory or farm, there's added difficulty in auditing quality and consistency, and a source of unwanted variation in the end product. It's feasible to comb over one factory to look for quality problems, but not for hundreds of suppliers around the world.
sebasmurphy 7y ago
The CDC response seems very measured and not over the top at all. Some of this may have to do with how the news is actually reporting on the matter. For reference, here is published recommendation from the CDC website. "While this investigation is ongoing, consider not using e-cigarette products. If you do use e-cigarette products and you experience symptoms like those reported in this outbreak, seek medical care promptly. CDC and the FDA will continue to alert the public throughout this investigation. ..." https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html#recommendations-public https://www.cdc.gov/tobacco/basic_information/e-cigarettes/s...
bfuller 7y ago
>One case was confirmed from a dispensary in Oregon can you source this for me? i keep hearing it but cant confirm
- joveian 7y ago
  The last I saw in the Oregonian a few days ago they said that they suspect it is from one of two dispensaries but are not certain. Possibly they confirmed since then but I haven't seen it in the news at least if so. The article (generally better than the submitted one IMO): https://www.oregonlive.com/marijuana/2019/09/vaping-death-and-outbreak-of-severe-lung-disease-linked-to-marijuana-oil-in-e-cigarettes-what-we-know.html https://www.oregonlive.com/marijuana/2019/09/vaping-death-an...

atlasunshrugged 7y ago

As someone who was in the industry, what do you think about the argument of vaping being a safer alternative? I see pretty mixed things in the health community but it's tough because some of the argument seems to be that the tobacco industry has acted nefariously in the past so we can't trust any innovation in the space. Is there any known experience similar to vaping/smoking of today that has really minimal health consequences but maybe isn't as addictive?

rkangel 7y ago
If you are an existing smoker and if your device and liquid are from a reputable supplier, absolutely yes. The problem is that a lot of the industry is not reputable and not well controlled. This means that you can get liquids that contain all sorts of things and devices that heat in an uncontrolled way. Even the perfect liquid if overheated (as it is in many large devices) produces aldehydes. As you might expect, breathing formaldehyde is bad. The industry also seems to be taking the opportunity to up the nicotine numbers, so if your intention is to give up that's not helping.
johngrefe 7y ago
I think it's a lot safer than smoking, there's probably a lot safer methods, but vapings efficacy vs other quit methods is just too good to discard for even slight health risks vs smoking. Only Juul/Pax has a hidden Big Tobacco interest, the rest are either overt or companies that are dedicated to vapor only. Almost all the innovation came from outside Big Tobacco, but all that is coming to an end with FDA'S regulations of Vaping. No new products so I left, since I exclusively designed hardware. Most vapor products can be used with eliquid that has varied levels of nicotine and most shops were (2012-2017) very active in promoting customers to reduce their nicotine level to 0, so addiction to the devices can be self regulated if that is your goal.
- atlasunshrugged 7y ago
  Okay, didn't realize it was only Juul/Pax that had that hidden interest. I'm mainly in Eastern Europe these days and Philip Morris is pushing IQOS hard (I know it's in a different category but I think it eats at the same market share, younger more affluent health-conscious users who know cigs are bad but still want to smoke something) You mention there probably being safer methods - any idea on them or where I should look for more info? I've been researching tobacco, mainly taxation (which in theory is one of the most powerful ways to get people to quit things, by jacking up the prices) but I'm generally interested in the field, and it seems to me that a potentially even better methodology than making things too expensive for many to afford is to innovate and develop something that's just way healthier a replacement that gives consumers the same benefits.
  - rkangel 7y ago
    Yes, Juul was bought for $4bn by ALCS which is the parent company behind Philip Morris USA, Marlboro and many other brands. Philip Morris International (i.e. Europe) is technically a separate entity. They were separated out a while ago (probably to avoid anti-trust issues). In theory they share stuff with the US but the separation is why you're getting different products.
- rkangel 7y ago
  Interestingly, one big manufacturer I worked with specifically avoided making their device a 'cessation aid' - something to help give up. You can think what you want about their motivation, but the explanation they gave is that if you are a cessation aid then you get into medical device territory and so hit a load of extra regulation.
Reelin 7y ago
> vaping being a safer alternative A safer alternative to what? Smoking cigarettes? There's absolutely no question that it is. One is a plant product (smoke is bad to inhale) that naturally contains a number chemicals that you probably don't want to be consuming. On top of this, there are additional additives (which vary by manufacturer) that also have significant health effects. Overview (https://en.wikipedia.org/wiki/List_of_additives_in_cigarettes https://en.wikipedia.org/wiki/List_of_additives_in_cigarette...) and more details (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2040350/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2040350/). The other is almost entirely a mixture of Propylene Glycol and Vegetable Glycerin. ...except when it isn't, as seems to be happening here. The safety of vaping is entirely dependent on what's in the liquid you're vaporizing; always keep that in mind when purchasing it. Also, do bear in mind that it's probably not fantastic for your health to be chronically inhaling anything other than highly purified air, no matter how benign it may seem. Relative to smoking cigarettes (or any other plant product), it's much safer. Relative to not vaping at all, there are likely to be at least some health risks, even if they haven't been clearly established yet. > Is there any known experience similar to vaping/smoking of today that has really minimal health consequences but maybe isn't as addictive? If you're asking about drugs with similar effects to nicotine that are less addictive, I'm not aware of any. You could always purchase vaping liquid that doesn't contain any nicotine though.
- atlasunshrugged 7y ago
  Sorry, yes, safer alternative to smoking cigarettes Fair enough, I'm sure it's not healthy to chronically inhale anything other than air > If you're asking about drugs with similar effects to nicotine that are less addictive, I'm not aware of any. You could always purchase vaping liquid that doesn't contain any nicotine though. I was asking that but a broader question for me is, are there any safe replacements for cigarettes out there that match the qualities that cigarettes have without the harmful side effects (the idea being if you could create something that was just as fulfilling, addictive, etc. but without the negative side effects you could dramatically decrease the health toll of cigarette smoking). You could argue vapes are that product but it seems like the jury is still out on how much better they actually are than cigarettes and the trouble with attracting new users into the market

wil421 7y ago

My local news ran a segment about THC vapes. Some local doctors were talking about an increase in vape related hospital visits. They interviewed the guy and he basically said he bought a random THC vial from some guy who walked up to him on the street. He said it didn’t feel right and was probably spice or something synthetic. Be careful, YMMV.

fukbezos 7y ago

Is there any way to test carts for vitamin E? If not I think I've just identified a market ripe for the picking.

cptskippy 7y ago

In all my experience working for a non-profit that closely involves itself with the CDC and smoking related research, I would never describe the CDC's actions as over-the-top. They do all their own research and are very measured and even handed with their messaging. Contrast that to the FDA who have outsourced their job function to back to the companies they're supposed to be regulating.

tdy_err 7y ago
Three are and have always been three components of e-liquid: - propylene glycol (used in ice-cream soda etc) - vegetable glycerin - food flavoring Besides proportions changing the only other variant is the type of flavoring. It's not actually too complicated. And If one of those ingredients was suddenly tainted people using vaporizers would not be the only ones affected, of course.
- zaphar 7y ago
  All three of those elements are not usually vaporized and then inhaled in large quantities. Extrapolation from their effects when ingested is unlikely to apply in these cases. Your conclusion does not follow from the evidence.
  - ad-hominem 7y ago
    propelene glycol is and has been used as an air santizer for a very long time. https://archive.epa.gov/pesticides/reregistration/web/pdf/propylene_glycol_red.pdf https://archive.epa.gov/pesticides/reregistration/web/pdf/pr...
    - cptskippy 7y ago
      In your document the Cat 4 exposure dose was stated to be 2.34 mg/L, a recent study[0] found that inhalation exposure at 0.442 mg/L resulted in slight irritation. What's the exposure when vaping? The document you link to actually avoids addressing Aggregate Exposure by stating there's insufficient information to draw any conclusions. > "Since toxicological endpoints for risk assessment were not identified based on the available data, an aggregate risk assessment was not conducted for propylene glycol and dipropylene glycol." Isn't Aggregate Exposure what we're concerned about with Vaping? Additionally these studies all talk about aeroslized or nebulized pg, vaporizers are thermal in nature. Does heating pg matter? The CDC is basically saying "We don't know what this shit does because no studies have ever exposed people to it in this manner. Until we know more you should probably not vape it". [0] Dalton P, Soreth B, Maute C, Novaleski C, and Banton M (2018). "Lack of respiratory and ocular effects following acute propylene glycol exposure in healthy humans". Inhal. Toxicol. 30: 124–132.

urbanjunkie 7y ago

LMFAO You: "I work in the vaping industry and i urge everyone to ignore the CDC's advice until I've exited" HN: "sounds reasonable, a millennial engineer must know more than the CDC. Have some upvotes"

Scoundreller 7y ago

VitE can be used as an antioxidant/preservative. VitC is too, but E is fat soluble.

_fullpint 7y ago

> While many of the patients, but not all, reported recent use of THC-containing products, some reported using both THC- and nicotine-containing products. A smaller group reported using nicotine only. That’s directly from the CDC. They should probably stop using the word e-cigarette especially due to the fact nobody using the THC vapes calls them that.

JoeAltmaier 7y ago
Curious linguistic detail: they need to use the word that people using THC vapes expect them to use for clear communications to occur. As a stuffy international organization, they'd be expected to use something that sounds like a technical term. Vs for instance, some slang or cool-kid term.
- thedaemon 7y ago
  They are called "cartridges".

lonelappde 7y ago

Interesting consequence of the global supply chain (really, network). For every ingredient or process sourced from a different manufacturer or factory or farm, there's added difficulty in auditing quality and consistency, and a source of unwanted variation in the end product. It's feasible to comb over one factory to look for quality problems, but not for hundreds of suppliers around the world.

sebasmurphy 7y ago

The CDC response seems very measured and not over the top at all. Some of this may have to do with how the news is actually reporting on the matter. For reference, here is published recommendation from the CDC website. "While this investigation is ongoing, consider not using e-cigarette products. If you do use e-cigarette products and you experience symptoms like those reported in this outbreak, seek medical care promptly. CDC and the FDA will continue to alert the public throughout this investigation. ..." https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html#recommendations-public https://www.cdc.gov/tobacco/basic_information/e-cigarettes/s...

bfuller 7y ago

>One case was confirmed from a dispensary in Oregon can you source this for me? i keep hearing it but cant confirm

joveian 7y ago
The last I saw in the Oregonian a few days ago they said that they suspect it is from one of two dispensaries but are not certain. Possibly they confirmed since then but I haven't seen it in the news at least if so. The article (generally better than the submitted one IMO): https://www.oregonlive.com/marijuana/2019/09/vaping-death-and-outbreak-of-severe-lung-disease-linked-to-marijuana-oil-in-e-cigarettes-what-we-know.html https://www.oregonlive.com/marijuana/2019/09/vaping-death-an...