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Kerri: Right. We all saw headlines about the cartridge-based e-cigarettes—the Juul brand, for example—that particularly appealed to young people because they’re more easily concealed. When the EVALI outbreak started, I know the investigation was complicated by the fact that patients would have used multiple products. For instance, an e-cigarette like a Juul, maybe also a cannabis-based vaping product, and some people were smoking traditional cigarettes, too. All of that had to be evaluated, right?
Britt: Right. A lot of the patients were doing both nicotine and THC products. So there was confusion over what was causing the illnesses. We also don’t know a lot about what’s in these products. So that’s, you know, if you don’t know what it’s in them to begin with, it’s kind of hard to figure out what’s causing the problem.
Kerri: And in this episode we’ll hear from some of the scientists who are trying to answer that exact question: Exactly what is in these things. And what happens when the chemicals in these vape juices get into your lungs. The EVALI outbreak seems to have drawn a lot of attention to this issue.
Britt: Absolutely. I think people are more concerned about what is in the vaping products than they were before. I think what really came out was how much we don’t know about what is in these products, particularly the flavors. Some of the chemicals in vaping liquids might be perfectly safe when ingested, but we know very little about what they do to your lungs. They simply weren’t designed to be inhaled.
Kerri: We’re going to come back to our prime suspect in the EVALI case, vitamin E acetate, a little later in the episode. But even before the spike in lung injuries last year, scientists had been exploring vape juice and raising concerns about its health effects. Robert Strongin is one of them. He’s an organic chemist at Portland State University who started studying vape juice after seeing the products crop up all around campus and in Portland.
Robert Strongin: You know, it seemed all of a sudden one day they were everywhere. They seemed to pop up very, very quickly. We basically were very suspicious. These were being touted as safe, completely safe materials made up of water vapor. And there’s very little water in these.
Kerri: What Rob’s talking about here are e-cigarettes that deliver nicotine. The vape juices in these devices dissolve nicotine primarily in a pair of solvents: propylene glycol and vegetable glycerin, nicknamed PG/VG. Both chemicals are commonly used in personal care products and as food additives. The propylene glycol is a thin, runny liquid that helps prevent vape devices from gunking up, and it produces a throat sensation that some users prefer because it’s similar to the experience of smoking tobacco. The glycerin has a slightly sweet taste, and it helps create those big clouds of white vapor you see. And there are also some flavoring compounds in the mix.
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