Major Constituents of Cannabis Vape Oil Liquid, Vapor and Aerosol in California Vape Oil Cartridge Samples

Abstract

During the E-cigarette or Vaping product use Associated Lung Injury (EVALI) outbreak of August 2019 to February 2020, the California Department of Public Health, Food and Drug Laboratory Branch received numerous cannabis vape oil cartridge investigation samples from throughout the state. Many of these products were directly linked to patients; others were collected as part of investigations. We determined the major ingredients and additives in twelve unused cannabis vape oil cartridge samples obtained before (n = 2) and during the EVALI outbreak (n = 10) in California from September 2018 to December 2019. We tested for major constituents in vape oil liquid, vape oil vapor, and vape oil aerosol phases. A nontargeted Gas Chromatography Mass Spectrometry direct injection screening method was developed for vape oils, a headspace heating module used for vape oil vapors and a solid-phase microextraction (SPME) vaping rig for aerosols generated by vaping. We have identified more than 100 terpenes and natural extracts, 19 cannabinoids, and other potential toxic additives such as Vitamin E Acetate, Polyethylene Glycols, and Medium Chain Triglycerides. We determined more terpenes and minor cannabinoids can be produced via vaporizing and aerosolizing the vape oil. Delta9-THC and potential toxic additives were found at lower levels in the vapor and aerosol than in the vape liquid.

Chemical Emissions From Heated Vitamin E Acetate—Insights to Respiratory Risks From Electronic Cigarette Liquid Oil Diluents Used in the Aerosolization of Δ9-THC-Containing Products

“…Public health messaging, the removal of VEA from electronic cigarette liquid (e-liquid) formulations, and law enforcement practices might have led to the decline in emergency department visits related to e-cigarette, or vaping, products (EVPs) (1). As of January 14, 2020, 82% (1,658/2,022) of hospitalized EVALI patients reported using products containing 9 -tetrahydrocannabinol (THC), 33% reported exclusive use of THC-containing products, 57% reported using any nicotine-containing product, and 14% reported using only nicotine-containing products (1). According to the (5), the cannabis plant is referred to as "marijuana" when the plant contains more than 0.3% by dry weight of 9 -THC, the main psychoactive cannabinoid, and referred to as "hemp" when the plant contains <0.3% of 9 -THC (2018).…”

“…As of January 14, 2020, 82% (1,658/2,022) of hospitalized EVALI patients reported using products containing 9 -tetrahydrocannabinol (THC), 33% reported exclusive use of THC-containing products, 57% reported using any nicotine-containing product, and 14% reported using only nicotine-containing products (1). According to the (5), the cannabis plant is referred to as "marijuana" when the plant contains more than 0.3% by dry weight of 9 -THC, the main psychoactive cannabinoid, and referred to as "hemp" when the plant contains <0.3% of 9 -THC (2018). Marijuana is the most popular illicit/recreational drug in the United States with ∼123 million people (age 12 + years) who have tried it at least once in their lifetime and ∼41 million people who have used it in the past year (6).…”

“…Of current adult EVP users, 17% reported using marijuana and 70% reported using nicotine (7). Among college students, 75% of those who reported using a substance other than nicotine in EVPs responded that they used marijuana or 9 -THC-containing products (8).…”

“…Cannabis extracts are hydrophobic, semi-solid materials. During the time of the EVALI outbreak, illicit 9 -THC products were shown to commonly be diluted with terpenes, VEA, medium chain triglycerides, and polyethylene glycol (9,10). VEA is strongly associated with EVALI and has been identified in bronchoalveolar lavage specimens from 48 of 51 EVALI cases in 16 states, giving direct evidence at the site of injury (2).…”

A Comparison of Vaping Behavior, Perceptions, and Dependence among Individuals Who Vape Nicotine, Cannabis, or Both

“…Nicotine vapes are typically used with e-liquids containing solvents (e.g., propylene glycol and vegetable glycerin), nicotine base or salt formulations, and flavor additives [ 12 ]. Cannabis vapes primarily contain cannabis-derived ingredients, including tetrahydrocannabinol (THC), cannabidiol (CBD), and terpenes, along with many other constituents used as fillers [ 13 ]. The Monitoring the Future Survey found that, in 2021, 18% of 12th graders and 12% of 10th graders reported vaping cannabis in the past year [ 14 ].…”