While no specific cause for these illnesses and deaths has been conclusively identified, investigators in New York are currently looking at vitamin E acetate. High levels of vitamin E acetate have been found in nearly all vaping products that contain cannabis that health officials in that state have analyzed.

“Vitamin E acetate is a commonly available nutritional supplement that is not known to cause harm when ingested as a vitamin supplement or applied to the skin,” a release from the New York State Department of Health reads.

“However, the Department continues to investigate its health effects when inhaled because its oil-like properties could be associated with the observed symptoms.”

Inhaling vitamin E vapours have been linked with respiratory issues in the past.

According to a case report published in the Canadian Respiratory Journal in 2000, a patient at McMaster University Medical Centre in Hamilton was diagnosed with lipoid pneumonia. It was later revealed she had been inhaling homemade cannabis oil on a daily basis for more than a decade.

According to the report, cannabis leaves would be combined with isopropyl alcohol, heated to distill and collect the vapour.

“The resulting mixture was burned for a short period to eliminate the alcohol, and then mixed with petroleum jelly, vitamin E or another oil-based substance and placed in a closed container,” the report reads.

“This mixture was heated and the vapours inhaled.”

In his email, Vickers says compounds like vitamin E are not in any of his company’s products, and would only be found in illicit products.

Investigators in New York have found that nearly all of the cannabis vaping products they have analyzed contain high levels of vitamin E acetate. The New York State Department of Health says the oil-like properties of vitamin E acetate could be linked with the symptoms seen in those who have developed vaping-related illnesses. | New York State Department of Health

“I can assure with you 1,000% certainly that none of our products contain anything even remotely close to additives such as vitamin E, food colouring or anything outside our listed and regulated ingredients,” he wrote.

“I also own and operate a manufacturing facility for these liquids and we follow very strict Health Canada guidelines, as well as use ISO clean rooms and ISO production standards. Those compounds and additives are specifically used in THC distillate cartridges and them only.”

Health Canada is advising those who vape to keep an eye out for symptoms of pulmonary illnesses, such as cough, shortness of breath and chest pain, and to seek medical attention as soon as possible if they have any concerns.

“Canadians are reminded that the purchase of vaping products outside the legal market may create additional risk as these products are unregulated and potentially unsafe, and thereby pose a risk to health and safety,” a post on Health Canada’s website adds.

Other studies have shown that there may be health repercussions from vaping.

A study published in the Journal of the American College of Cardiology in May found evidence that acute exposure to flavoured e-liquids exacerbates endothelial dysfunction, a condition where the inner lining of small arteries fail to perform normally.

According to the study, this often precedes cardiovascular diseases.

Another study, published in the Journal of Clinical Investigation earlier this month, found evidence that chronic exposure to the vapours from e-cigarettes and other vaping products in mice could lead to issues with the lungs’ protective layers and impact how the body responds to infection.

Amy Estill, the manager of health promotion for Wellington-Dufferin-Guelph Public Health, says the agency is currently taking a precautionary approach to vaping.

“There’s still a lot of emerging evidence around vaping, and there are a lot of unknowns still around the impact of vaping on people’s health, both short term and long term,” she says.

“We are recommending that if you don’t smoke or vape, don’t start.”

Estill adds there has been limited evidence that vaping can help smokers kick the habit.