Deadly vaping lung illnesses are cropping up across the US, and experts blame everything from vegetable oil to ‘Dank Vapes’

In theory, vape users should not be ingesting any liquid oils when they inhale, only the vapor from e-cigarettes that looks like white smoke.

In practice, that's not always what happens. 

Because solvents like propylene glycol and vegetable glycerin (PG-VG) are commonly used to deliver drugs to vapers (everything from cannabinoids to nicotine) there is always the chance that a rogue oil may not get completely transformed into vapor, instead traveling into the lungs as a liquid and causing harm. 

Vitamin E acetate (which is in oils including canola, soy, and corn) vaporizes at 363 degrees Fahrenheit, well above temperatures at which some people vape.

Investigators who were on a briefing call between the FDA and state health agencies recently told the Washington Post that vitamin E acetate has been found in cannabis samples from numerous sick patients who'd vaped in New York.

It could be the case that this vitamin oil, which is meant to harmlessly deliver drugs, is ending up in people's lungs as a liquid. Then, the body mounts an immune response to the invasive substance, prompting pneumonia.

In July, an unnamed man used a cannabis vape vial off the street in Wisconsin and was later hospitalized and put on life support.

As Inverse recently reported, there's a growing market for these cartridges, which use cannabis distillates in a liquid form rather than marijuana flower to get users high. Sellers can open and tamper with these distillate vials, adding other ingredients to make their supply last longer.

"I think this is probably going to be associated with illegal products," Gottlieb told the New York Times. "It's not like the major manufacturers have suddenly changed their ingredients. It's probably something new that has been introduced into the market by an illegal manufacturer, either a new flavor or a new way to emulsify THC that is causing these injuries."

People who sell "Dank Vape" brand devices on the black market market them as premium marijuana consumption devices, but the person who is running the business is a mystery, according to Inverse.

Dank Vapes continues to grow because it offers an accessible marijuana option in states where the drug is still illegal, plus a more inexpensive option in states where legal cannabis is available.

The business is popular enough that others have started copying it with their own "Dank Vapes," making the name itself even more mysterious and difficult to track.

"These are just people filling cartridges as 'Dank Vapes.' It's not a singular facility. It's just people in their garages filling them and selling them," Mark Hoashi, the founder of the Doja app, told Inverse.

The composition of nicotine-containing vape juices varies based on flavor and brand, but according to pulmonologist Dr. Ravi Kalhan, a professor at Northwestern's Feinberg School of Medicine, certain chemicals that raise health concerns are found in a wide range of these products.

"There's some disturbing stuff in these things, an endless number of chemicals," Kalhan told Insider.

Kalhan said some e-cigarettes produce formaldehyde, a chemical that can cause lung disease. The Environmental Protection Agency classifies formaldehyde as a "probable human carcinogen," which means inhaling the substance could increase a person's cancer risk.

In 2018, The American Chemical Society found that people who inhaled acrolein sustained changes to their DNA. "If the cell does not repair the damage so that normal DNA replication can take place, cancer could result," a press release on the research said.

The chemical, which releases when gasoline is burned, has been linked to lung and gastrointestinal problems, according to the National Institutes of Health.

"Just be aware that from the lungs' perspective, vaping doesn't seem to be better than smoking,"  Professor Robert Tarran, who studies vaping at the University of North Carolina Marisco Lung Institute, told Insider.

His recent studies, and others like them in both animals and people who vape, suggest that vaping leads to more lung diseases, just like smoking does. Tarran is starting to think that vaping nicotine may not actually be much better than burning tobacco when it comes to long-term lung health. 

"People who vape who've never smoked, they're part of a whole new kind of social experiment," he said. "Do they really want to be the guinea pigs?"

It's still early days for e-cigarette research, but a new study out Wednesday in the Journal of Clinical Investigation suggests that mice lungs are hurt by vaping, regardless of whether their rodent-friendly e-cigarettes include any nicotine or not. 

More studies in people are needed to know for sure, but this is some of the first evidence we have that suggests vaping of any kind can hurt lungs.

Mice that used e-cigarettes over a period of four months (a timeframe meant to mimic years of e-cig use in people) ended up producing more fat deposits in their airways, which could make them more susceptible to illnesses and infections like pneumonia, even when there's no nicotine involved. 

"I think there's an emerging consensus that the immune cells of the lung are a little bit upset by vaping," Tarran said. 

"Sometimes, we see people who develop a mysterious respiratory illness and don't know what caused it. It's not always something we always ask about, vaping," Kalhan said. 

Recent media coverage of vaping illnesses may have changed that.

Case studies of vaping injuries go as far back as 2012, when a 42 year old woman was seen multiple times in the ER and prescribed "several courses of antibiotics" before doctors finally told her to stop using e-cigarettes. Only then did her symptoms improve.

Professor Thomas Eissenberg at the Virginia Commonwealth University Center for the Study of Tobacco Products showed Insider six other cases that have been documented in medical journals around the world since then. 

"Anything other than air and oxygen is an insult to the lungs," he said. "The critical thing here is that all of those cases cry out for regulation."