The tragic deaths of THC vapers and the implications for cannabinoids and nicotine
The best science reliably informs us that vaping standard conventional e-liquid (with propylene glycol, vegetable glycerine, flavouring and nicotine) is 95% less harmful than smoking cigarettes. Then why did the CDC (Centers for Disease Control and Prevention) announce in September 2019, they were saddened to hear about the first death from vaping in such a dramatic fashion in a press release which now appears to have been taken down? Unfortunately, the news was pounced upon and reported widely (1, 2, 3) before the facts and language where given the chance to be more objective and scientific. It would seem strange that these unexpected and sudden deaths were the result of vaping conventional e-cigarettes, was it true? No.
The deaths were in fact a result of vaping THC but THC was not the cause, rather the addition of Vitamin E acetate to the distilled liquid form. This type of vaping is almost an entirely different process with different constituents, vaped at a different temperature for different purposes. Then why might the CDC want to give the impression that these tragic incidents were the result of vaping generally? The best explanation might be that they were just trigger happy, believed the deaths to be from conventional vaping and wanted to put out a swift alert that that consumption of nicotine in e-cigarettes could be catastrophic. The worst assessment was that the political and corporate interests, encouraged by the overwhelming influence of academic and advocacy institutions have never liked vaping, either for commercial or philosophical reasons.
Let’s examine the commercial interests. Big tobacco is rich, has been rich and with the best science and tightest regulation in the world, represents a solid investment opportunity, particularly for pension funds for the next century, because in emerging economies with looser regulation, cigarettes sell into the billions. Cigarettes have made a killing and will continue to do so as long as they are able to employ the brightest minds to advocate against tighter regulation and evidence-based measures.
What does this mean for vaping, THC and cannabinoids?
The philosophical reasons, the US has a strange relationship with addiction. The opioid epidemic is rife as a result of an extensive commercial strategy by big pharma. Documentaries have been made and articles written but the sight of people out on the street, living in the open or underground in communities is not anyone’s American dream. There is a strong paternal and religious narrative in politics too, just say no campaigns targeting kids have been useless and damaging. In an attempt to acknowledge the failed war on drugs, there has been an acknowledgment that the criminalisation and lack of regulation might need an alternative approach. This might be partly the reason for the rational approach to regulate the cannabis market, where some US states have led the way. The role of any public health government initiative should be to make it easier and cheaper for its population to gravitate to the less risky choices. It would appear that this is not always the case, particularly with alcohol, tobacco, cannabis, prescription medicines or street drugs.
Commercial powerhouses such as British American Tobacco or Pfizer are yet to dominate the cannabis or nicotine market. Cigarettes and prescription medicines continue to be lucrative and their sellers have an obligation to shareholders to protect these interests.
In some circumstances this requires undermining disruptive and emerging technologies and science. We know more about nicotine, addiction and cannabinoids than before. And we know that while nothing is risk free, there are ways to consume these constituents free from smoke and free from the psychoactive inducing effect.
Unless Governments can both regulate and incentivise industry to move towards less risky alternatives, enterprise will hold firm on the biggest bang for buck products. Change for enterprise is not easy or welcomed. It takes strong advocacy and science for objectivity to win. But in the context of fake news, climate change deniers and numerous conspiracy theories, these arguments need to be fought harder than ever. I remain optimistic that the right outcome will prevail against the odds, it won’t be easy.
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