Most Americans believe:
That nicotine vaporization products are the cause of the recent vapor-induced lung injuries that killed 60 people and hospitalized more than 2,700 others. According to a recent survey by Morning Consult, only 28 percent of the public understand that illegal, adulterated THC Vape cartridges, not nicotine products, are responsible for the injuries.
The survey, published last week, measured the beliefs of 2,200 adults in the last week of January. Morning Consult conducted a similar survey in September last year, when the outbreak of lung injuries was just reaching its peak. Both surveys show an error rate of two percent.
More people now believe that nicotine-containing wrap products caused the lung injuries than last autumn. In September, 58 percent of those surveyed wrongly believed that “e-cigarettes like Juul” were responsible for the injuries. In January, the figure had risen to 66 percent. And the percentage who rightly blamed THC vaping products fell from 34 to 28 percent.
What changed between September and the end of January?
The answer is obvious: more people have heard and believed the wrong messages from the Centers for Disease Control and Prevention, either directly from the CDC or filtered through uncritical media coverage of the agency’s findings.
The agency never definitively believed that an additive used in illegal THC cartridges was the only logical cause of lung injury. Vitamin E acetate is a thick, oil-soluble, tasteless and odourless substance that is ideal for diluting cannabis oil. Since THC cartridges on the black market are never tested in the laboratory for their effectiveness, consumers cannot say whether the products they have bought are 90 percent hashish oil or 50 percent – or even less. Unscrupulous cannabis processors doubled or tripled their money by cutting the oil in the trolleys they sent to street vendors. It would have been perfect except for one thing: breathing in vaporized vitamin E acetate can kill you.
Even before Leafly published its first story about vitamin E acetate in black-market THC oil cartridges on August 30, there was extensive evidence that the outbreak of lung injury was caused by something in black-market THC oil cartridges. When the Leafly story was published, only one person had died and 215 had been hospitalized.
Had the CDC decided at that time to issue a bulletin warning all cannabis vapers that they were risking their lives by using illegal THC cartridges, it would have been broadcast in every newspaper and on every radio and television show in the country. Word of this would have spread quickly. Instead, the agency played a game of dancing around the truth, and unsuspecting cannabis oil dealers continued to get sick and die for months.
The CDC deliberately avoided using the terms actually used by the cannabis oil papers to describe the products that cause the lung injuries. Instead, the health authorities misled the public by suggesting in their communications that nicotine patch products were at least partially responsible – and continue to do so.
In fact, from the beginning, the agency has tried to link the term “e-cigarette” to the outbreak. In its August 30 health alert for health professionals, the CDC used the term “e-cigarette” 45 times, although there is no hard evidence that nicotine products were responsible for any of the lung injuries.
When the CDC officials decided to give the lung injuries a clear, memorable name, they chose “E-cigarette or Vaping, product use associated lung injury” (“EVALI”). The creators of the cobbled term deliberately put “e-cigarette” at the front of the name. The message was clear: e-cigarettes can kill you.
The term “e-cigarette” is understood by all newspapers to refer only to nicotine products. Despite a similar vaporization process, cannabis oil and nicotine vaporization devices are not interchangeable – nor are the terms used to describe the two types of vaporizers.
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Cannabis Oil Vapers never call their products “e-cigarettes”.
THC Oil Strips are pre-filled cartridges containing one gram or less of honey-like cannabis oil. They are all sold as Vape-Carts, THC-cartridges, hash oil trolleys, Vape-pens, oil-vapers or a variation of these terms.
THC oil strips are pre-filled cartridges containing one gram or less of honey-like cannabis oil. Without exception, they are referred to as vape-carts, THC cartridges, hash oil carts, vape pens, oil vapens or a variation of these terms. E-cigarettes are not used to vape cannabis oil.
Effective public health communication requires the use of language that is understood by the target group. By using “e-cigarettes” to describe THC products, the CDC demonstrated that it has little concern for the well-being of cannabis users, who were the direct victims of “EVALI”. And by advising all newspapers to stop using “e-cigarettes”, the agency also showed that it does not care about the millions of nicotine newspapers that are in danger of returning to flammable cigarettes.
The CDC was so far from the real dangers that representatives and activists of the legal marijuana industry did their best to bypass the federal agency and warn the cannabis vapers on their own. Leafly, Merry Jane and the Marijuana Times have all published articles warning cannabis oil dealers of the dangers of black market products.
In early October, more than 800 legal cannabis companies and the National Cannabis Industry Association sent a letter to Congress begging for nationwide cannabis regulation. And in view of the CDC’s inaction, the California section of the advocacy group NORML issued its own warning to the THC Papers. Even former FDA commissioner Scott Gottlieb reprimanded the CDC for its imprecise language and ruthless anti-vaping position.
In December, as the CDC slowly retreated from its warnings that people should completely avoid all vaping, the agency never clearly identified the threat as adulterated black market THC cars. The CDC never conducted a clear, understandable information campaign to reach the most vulnerable people. Now 60 people are dead and hundreds or thousands more will suffer long-term lung damage.
“The initial panic over the evaporation-related disease caused a furore, but the updated conclusion has barely made itself felt in the main news,” says Sara Wilson of Morning Consult. But the CDC has never really issued a conclusion or made any serious effort to openly correct the report.
Rather, the CDC has only tilted its low point of uncertainty a few degrees towards the truth and allowed dribs and drabs to spread. As recently as January 17, the agency published the advice of its scientists to avoid all products that spread to the public.
“As the investigation continues,” they wrote, “the CDC recommends that the best way for people to ensure that they are not at risk is to avoid all e-cigarettes or vaping products.
We can only assume – after months of evidence – that the CDC’s goal all along has been to scare as many people as possible from vaping. The agency used all its resources and all its credibility to convince the Vapers to give up e-cigarettes. The CDC was willing to risk the lives of millions of cannabis users to achieve its goal of a nicotine-free society.
The CDC’s deliberate merging of the two types of vaping products almost certainly resulted in injuries and deaths from THC vaping that would not have occurred if the agency had instead opted for a clear, unambiguous message strategy. In addition, the confusion has led thousands, or perhaps hundreds of thousands, of nicotine vapers to drop their e-cigarettes and return to combustible tobacco.
Worst of all, there is no telling how many of the nation’s 34 million smokers will now continue to smoke cigarettes instead of switching to vaping, which is far safer by all objective measures. According to the CDC, half of long-term smokers die prematurely – and many more suffer from serious diseases such as cancer, heart disease and COPD.
The Morning Consult survey found that an astounding 74 percent of Americans now believe that e-cigarettes are “just as or more harmful than” cigarette smoking. This figure is more than 50 percent higher than in June 2018, when the polling company first asked the question.
Among the people who believe that vaping is just as bad as smoking – or worse – are not only the smokers themselves, but also friends and family members who will now urge and nag their loved ones to avoid Vaping. And they will do it because they believe in the message of the nation’s public health advocate: CDC.