Yale University: States Where Marijuana Is Legal Are Not the Ones With the Highest Rates of Lung Injury (EVALI)

A Yale University study shows that the States with the highest rates of marijuana use and vaping are not the ones with the highest rates of lung injury.

Vaping

The lung damage that led to 68 deaths in the United States and one death in Belgium last year was not caused by the use of marijuana or electronic cigarettes, according to researchers at Yale University’s School of Public Health in the United States. In a study published in Addiction magazine, they estimate that the global relationship between the total number of cases of lung injury associated with the use of electronic cigarette products or vaping is not related to vaping and the use of cannabis.

On the contrary, in the States with the highest rates of marijuana use and vaping, the number of e-cigarettes, or vaping, product use-associated lung injury (EVALI) cases per capita has decreased.

“If consumption of electronic cigarettes or marijuana per capita is driving this epidemic, the areas where these behaviors are most prevalent should have a higher prevalence of EVALI,” says Assistant Professor Abigail Friedman. This study reaches the opposite conclusion. “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.”

Vitamin E acetate in question

Last August, the Centers for Disease Control and Prevention (CDC) – the U.S. Department of Health and Human Services – began an investigation into lung injuries related to the use of THC E-liquids after finding 2,800 cases, 68 of which were fatal. Authorities eventually concluded that vitamin E acetate, an additive found in homemade THC E-liquids, was the cause of the lung damage.

This epidemic had then led federal authorities to pass several laws to restrict the sale of electronic cigarettes containing nicotine or ban flavorings, or even ban all sales of electronic cigarettes, as was the case in Massachusetts in late 2019.

For the authors of the study, the authorities were on the wrong track for reducing EVALI’s risks, since the danger came from e-liquids sourced informally.

In particular, they relied on data from the first five states to legalize marijuana for recreational use. Alaska, California, Colorado, Oregon, and the state of Washington all had less than one EVALI case per 100,000 residents aged 12-64. In contrast, none of the states with the highest prevalence of EVALI (Utah, North Dakota, Minnesota, Delaware, and Indiana) has approved the recreational use of marijuana.

The results of the study should lead states to consider the possible unintended consequences of their policies prohibiting the consumption of marijuana while allowing the consumption of THC-E liquids.