MDHHS receives results of testing of vaping products from Michigan lung injury patients
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Oct. 25, 2019

CONTACT: Lynn Sutfin, 517-241-2112

LANSING, Mich. – The Michigan Department of Health and Human Services (MDHHS) is alerting vaping and e-cigarette users about recent test results the state received from the Food and Drug Administration (FDA) on vaping materials collected from lung injury patients in the state.

Lung injury patients are asked to provide any materials they have vaped for testing. Results received from FDA's preliminary testing of materials used by five lung injury patients in the state found:
  • Two patients' products contained only nicotine.
  • One patient's products contained only tetrahydrocannabinol (THC).
  • One patient's products contained both THC and nicotine.
  • One patient's products contained THC and vitamin E acetate. One product, a Dank Vape Birthday Cake THC cartridge, contained 23 percent vitamin E acetate.

The FDA lab results received by MDHHS is the first confirmation that a Michigan lung injury patient was exposed to vitamin E acetate.

In addition, two vaping cartridges submitted by a medical marijuana caregiver to a Michigan Marijuana Regulatory Agency licensed safety compliance facility also contained 40 percent or more of vitamin E acetate.

Although the cause of the lung injuries is not yet known, the majority of lung injury patients report using products with THC. One hypothesis being investigated is that contaminants in THC vapes, including vitamin E acetate, may be related to the outbreak. Other states are also finding vitamin E acetate in their testing. The New York State Department of Health found high levels of vitamin E acetate in nearly all cannabis-containing samples analyzed as part of its own investigation of lung injury patients. Product sample testing at the Utah Public Health Laboratory showed evidence of vitamin E acetate in 89 percent of THC-containing cartridges provided by six lung injury patients.

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"We urge Michiganders not to use e-cigarette or vaping products, particularly those containing THC," said Dr. Joneigh Khaldun, chief medical executive and chief deputy for health for MDHHS. "This outbreak is still under investigation, and the exact substance or devices that are causing the outbreak are unknown."

As of Oct. 25, Michigan has 44 confirmed and probable lung injury cases, with one death. About 81 percent of these patients reported using a product containing THC. Nationally, there have been 1,604 lung injury cases associated with the use of e-cigarette or vaping products reported to Centers for Disease Control and Prevention (CDC) from 49 states, the District of Columbia and one U.S. territory as of Oct. 24. There have been 34 deaths.

MDHHS continues to work closely with the CDC and the FDA to get additional information that can help identify the ingredients in the vape materials that are making people sick. So far, no specific brand of device or e-liquid has been identified. Although products with THC, particularly those obtained through informal or illicit sources, appear to play a major role in this outbreak, nicotine products cannot be excluded at this point.

Based on recommendations by the CDC, MDHHS has issued the following health advisory:
  • CDC and MDHHS recommend that persons should not use e-cigarette or vaping products, particularly those that contain THC.
  • At present, CDC and MDHHS also recommend individuals refrain from using e-cigarette or vaping products that contain nicotine.
  • E-cigarette and/or vaping products should never be used by youths, young adults or women who are pregnant.
  • Individuals who do not currently use tobacco products should not start using e-cigarette or vaping products.
  • Individuals should not buy any type of e-cigarette or vaping products, particularly those containing THC, off the street.
  • Individuals should not modify or add any substances to e-cigarette or vaping products that are not intended by the manufacturer, including products purchased through retail establishments.

Adults who are vaping should not smoke combustible tobacco products as a replacement for nicotine. E-cigarettes are not FDA approved as a smoking cessation device. Free help is available for individuals who are interested in quitting tobacco at 800-QUIT-NOW (800-784-8669).

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Teens trying to quit tobacco or stop vaping can call or text the My Life, My Quit program at 855-891-9989 for real-time coaching. This program allows teens to work with a coach who listens and understands their unique needs, provides personalized support and helps them build a quit plan to become free from nicotine.

E-cigarette and/or vaping users should immediately seek medical attention if they develop symptoms such as shortness of breath, chest pain, cough, fever and/or nausea and vomiting.

Information about the vaping-related lung injury for the public is posted at Michigan.gov/vapelung and for providers at Michigan.gov/cdinfo.

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