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.
Highlights
Medical cannabis became legal in California since 1996 under Proposition 215–the Compassionate Use Act (CUA)
Adding flavors into e-liquids for nicotine vaping is a common practice despite the possible health implications (Erythropel et al, 2019) and it is an increasing trend that various terpenes, flavor and fragrance agents are being added into cannabis vape products (Erickson, 2019)
We have detected over 100 terpenes and natural extracts, 19 cannabinoids including some minor cannabinoids such as cannabicitran (CBT), cannabivarin (CBV), cannabicounaronone, (6aR,9R)-delta10-THC, (6aR,9S)delta10-THC, 9(S)-delta6a,10a-THC, and Cannabifuran, exoTHC, and Hexahydrocannabinol, as well as other potential toxic additive such as Vitamin E Acetate (VEA), Polyethylene Glycols (PEGs), and Medium-chain triglycerides (MCTs) in tested vape cartridges
Summary
Medical cannabis became legal in California since 1996 under Proposition 215–the Compassionate Use Act (CUA). In November 2016, 57% of voters passed Proposition 64–the Adult Use of Marijuana Act (AUMA), leading to recreational cannabis sales in California (CDPH Legislation). A variety of cannabis products are available in California including joints, beverages (in different flavors), concentrates/distillate, vape cartridges (in different flavors), topicals, oral supplements, tinctures, capsules, and various infused edibles such as candies/chocolates, mint/chews, dried meat, crackers, dairy product and baked goods. Among these cannabis products, vape oil cartridges are popular as they share the electronic nicotine delivery systems (ENDS). ENDS use is not without short or long-term adverse effects due to additional chemicals generated in the system and the strength of active contents (Rehan et al, 2018; Livingston et al, 2019)
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