Public health officials have not yet specified how many deaths and illnesses are linked to cannabis vape products — but there is only one known case involving a person who purchased a THC vape pen from a legal cannabis dispensary . Several of the other cases appear to involve people who bought illicit vapes, which are not subject to any regulations or testing.

The demand for cannabis vapes has exploded over the past few years, and the illicit market has kept up with the trend. Consumers like vaping because it is more discreet and convenient than rolling a joint or carrying around a bong. Sellers like vapes too because the profit margins tend to be higher — especially on the illicit market, where sellers can save on costs by heavily diluting the THC oil.

This haphazard “do something” approach ignores the fact that several of the people who got sick from vaping used pens filled with THC oil, which is already illegal in most states and under federal law.

Over the past several months, seven people have died and nearly 400 others have gotten sick after using vape pens containing either nicotine or THC, the chemical in cannabis that makes you high. It’s causing a nationwide moral panic: Michigan’s governor enacted regulations that could result in 17-year-olds being hit with six-month jail sentences for every Juul pod in their possession. President Donald Trump has called for a similar nationwide ban on all flavored e-cigarettes.

“Our fail rate was much higher when no one was required to do it the right way,” Frazier said. “Without regulation, people aren’t going to do what’s right. This has been true in almost all industries.”

That’s because failing these testing requirements is a huge pain for cannabis companies. Products have to be quarantined. The manufacturer can either destroy the entire batch or submit a “corrective action plan” to the California Department of Public Health, which decides whether or not to approve the plan.

Back in 2017, before California’s testing requirements went into effect, around 70% of clients that submitted their product to cannabis-testing lab Cannasafe failed to meet standards the lab was using at the time, according to Antonio Frazier, the lab’s vice president of operations. These days, only 3-6% of Cannasafe’s clients fail to meet the state’s testing regulations.

A more effective way to prevent people from using marijuana vape pens that could kill them or make them sick would be to legalize weed so that consumers could have the option to buy regulated, lab-tested products. The public health benefit of legalizing and regulating marijuana is not hypothetical — it’s already happened in states that have done it. California now has the most rigorous testing requirements: Every cannabis product sold in a licensed dispensary is tested for 66 types of pesticides, heavy metals, microbial pathogens and potency.

Legalization and regulation isn’t a perfect solution. There is still a thriving illicit market in California for consumers who don’t want to pay dispensary prices or who live far away from licensed stores. In Oregon, one man died of a respiratory illness after using a marijuana vape purchased from a legal dispensary — although it is not yet clear whether he added anything to the oil or used illicit products in addition to the vape he bought at the dispensary.

The odds of puffing poison into your lungs are significantly higher when using an illegal vape manufactured by people who are subject to no oversight and who have little incentive to keep their products free of toxic additives — but there are still a lot of unknown risks associated with legal THC vapes, experts warn.

Cannabis oil naturally has a thick consistency that could get clogged up in a vape cartridge. “Just about every company is using some kind of thinning agent to make cannabis vape cartridges. The question is what?” Steven Palaia, a chemist who works in the vape industry, said.

Some of the legal vape manufacturers use terpenes, which are the oils that give cannabis its flavor, as thinners. Although this sounds like a safe, natural method, the effects of using large amounts of terpenes in vapes is still unknown, Palaia said.

“These are still organic solvents,” he said. “We don’t know what’s happening to them when they pass through high-temperature coils and end up in users’ lungs.”

There’s been an emergence of illicit THC vapes containing tocopheryl acetate, also known as vitamin E oil — seemingly a new effort to make the diluted oil appear thicker, according to cannabis industry experts. In the illicit market, where there is no required potency testing, thin oil can suggest low potency.

“We think the thickeners have been developed to mislead people in the illicit marketplace to think the THC concentration is higher,” Raber said.

Although safe for consumption and topical use, vitamin E oil when inhaled can stick to the lung’s liner fluid, block the flow of oxygen and kill lung cells.

At least some of the pens connected to vaping-linked illness included vitamin E acetate. New York’s Department of Health said it found “very high levels” of the compound in samples from eight of the 34 sick patients in the state. It also appeared in 10 of the 18 THC samples analyzed by the Food and Drug Administration earlier this month.

Despite having the strictest regulatory standards for cannabis, California law does not yet require products be screened for vitamin E acetate. At least one lab, Cannasafe, has already started offering the test.

Part of the problem for vape consumers is that it’s easy to make illegal vape pens that look legitimate enough to pass as legal, tested products. Empty carts and counterfeit labels are for sale in markets in downtown Los Angeles and online — although Amazon has started removing products that could be used to make counterfeit vapes. Until Amazon’s recent crackdown, the website sold “California compliant” stickers, which could be affixed to an illicit vape pen and give consumers the false impression that the product had been subject to extensive testing instead of cobbled together in someone’s garage.

One counterfeiting group that mimicked the branding of the licensed California vape company TKO Products managed to accumulate more Instagram followers than the real company’s account. In June, the fake TKO account posted what it claimed were test results from BelCosta Laboratories — the lab quickly noted in the comments of the post that the results appeared inauthentic.

The next month, an 18-year-old man was hospitalized in Long Island after suffering from “chest pain, nausea, fever and shortness of breath,” Rolling Stone reported. He was diagnosed with acute lung injury, connected to a breathing tube and placed in a medically induced coma for a week. The patient’s mother eventually found a counterfeit TKO vape cartridge in his trash can; his girlfriend confirmed he had used it three days before he was admitted to the hospital.

Part of the reason outlets like the fake TKO group have been able to thrive on selling poisonous products is because the federal ban on cannabis has created a massive market for illicit goods. Legalizing marijuana nationwide wouldn’t get rid of bad actors, but it would give consumers the choice to pay more for safer products.

Cannabis enthusiasts have been warning about the dangers of street vapes for years. In the absence of regulation from the federal government, anonymousInstagramusers have taken it upon themselves to test vape cartridges themselves and post the results.

Last December, an Instagram user who goes by “@dat_dude41510” posted lab results for a brand called “Dank Vapes,” which had failed CW Analytical Laboratories’ chemical residue screening. “This shit is terrible for you,” @dat_dude41510 wrote.

The self-appointed vape inspector was on to something. The New York State Department of Health identified Dank Vapes as one of the unlicensed vape companies adding vitamin E acetate to its THC oil. Dank Vapes looked like a legitimate brand — but there were multiple actors claiming to be the real Dank Vapes and its not clear that any of them were legitimate companies, Inverse reported. Until recently, anyone could buy Dank Vapes boxes on Amazon in bulk for about 36 cents each.

At least 24 of the patients who got sick reported using a Dank Vapes-labeled product, according to a study published last week in the New England Journal of Medicine. Doctors put one Dank Vapes consumer into a medically induced coma.