The study was originally published in the journal Addiction on August 25, and it attests that reported cases of EVALI (short for e-cigarette or vaping product use-associated lung injury) do not appear to line up with higher rates of vaping and cannabis consumption. In fact, higher rates of e-cigarette and cannabis vaping use were associated with fewer EVALI cases. “If e-cigarette or marijuana use per se drove this outbreak, areas with more engagement in those behaviors should show a higher EVALI prevalence,” said the study’s author, Assistant Professor Abigail Friedman. “This study finds the opposite result. Alongside geographic clusters of high EVALI prevalence states, these findings are more consistent with locally available e-liquids or additives driving the EVALI outbreak than a widely used, nationally-available product.”
According to data gathered from the Centers for Disease Control and Prevention (CDC), over 2,800 cases of EVALI and 68 deaths have been confirmed since August 2019. In February of this year, the CDC found that vitamin E acetate was the “primary cause of EVALI.” As a result, new legislation was crafted by many states and localities to protect consumers from EVALI risks. Friedman notes that out of the states that currently have legalized recreational cannabis, all of them had fewer than a single case of EVALI for every 100,000 residents between the ages 12-64. Interestingly enough, the states with the highest EVALI cases were actually Utah, North Dakota, Minnesota, Delaware and Indiana—none of which allow recreational cannabis consumption.
“If this policy led some recreational marijuana smokers to switch to vaping THC, perhaps in order to avoid detection, it would have increased their likelihood of exposure to contaminated e-liquids when those came on the market. This may have contributed to the higher EVALI prevalence in those states,” Friedman continued. She concludes that legislators take this into account in the future when writing policies that ban smokable cannabis versus not banning THC e-liquids.