ENDS EVALI VALI THCVALI: Difference between revisions

(5 intermediate revisions by the same user not shown)

Line 5:

<br>

The 2019–2020 outbreak of acute lung injuries in the United States ~~represents a pivotal juncture in modern public health communication~~. Designated by the Centers for Disease Control and Prevention (CDC) as EVALI (“E-cigarette, or Vaping, Product Use-Associated Lung Injury”), the nomenclature explicitly embeds commercial electronic nicotine delivery systems (ENDS) into the medical definition of the disease. This was maintained despite clinical, laboratory, and epidemiological evidence identifying vitamin E acetate in illicit, unregulated tetrahydrocannabinol (THC) cartridges—not standard nicotine e-liquids—as the demonstrated cause of the ~~outbreak~~.

The 2019–2020 outbreak of acute lung injuries in the United States was real. The name given to it was the problem.

The Centers for Disease Control and Prevention (CDC) named the outbreak “E-cigarette, or Vaping, Product Use-Associated Lung Injury,” or EVALI. That name embedded e-cigarettes and vaping into the medical language of the outbreak, even as clinical, laboratory, and epidemiological evidence increasingly pointed to vitamin E acetate in illicit, unregulated THC cartridges, not standard nicotine e-cigarettes.

~~This page compiles empirical journal data, formal policy critiques, and contemporary media analysis documenting how~~ the ~~"EVALI" designation generated an unprecedented public health information shock~~. By conflating ~~distinct product categories~~, ~~this nomenclature~~ distorted risk perceptions ~~globally. It led a majority of adult smokers~~ and ~~youth to mistakenly believe~~ that regulated nicotine vaping ~~was~~ the ~~cause~~ of the ~~injuries~~. ~~Consequently~~, ~~peer-reviewed economic~~ and ~~behavioral data demonstrate~~ that this ~~ongoing institutional misclassification severely disrupted tobacco harm-reduction efforts~~, ~~suppressed e-cigarette demand for smoking cessation~~, and ~~inadvertently drove~~ a ~~resurgence in combustible tobacco consumption~~.

The harm from the name “EVALI” did not end when the outbreak ended. By conflating nicotine vapor products with illicit THC cartridges, public health messaging distorted risk perceptions, contributed to widespread misunderstanding, and left many people believing that regulated nicotine vaping caused the injuries. That confusion affected many people. People who had switched from combustible tobacco to nicotine vaping went back to smoking. Some people who smoked tobacco became leery of switching. People using unregulated THC carts may not have recognized quickly enough that the warnings applied to the products they were using. With better messaging, some of the illnesses and deaths might have been averted.

This page documents efforts to get the CDC to correct that name, the consequences of leaving it unchanged, the scientific evidence identifying the source of the outbreak, and the people who tried to correct the record in real time. It does this by bringing together journal articles, formal policy critiques, media analysis, public health statements, and consumer-led documentation to show how one imprecise name became a lasting public health communication failure.

<br>

Line 228:

Line 231:

**Citation: Betuel, E. (2019, September 13). A thickener used in pot vaping is a hugely popular black-market scam. Inverse. Retrieved June 6, 2026.

='''EVALI outbreak - ~~THC vaping~~ research ~~notes compiled by people who vape~~, and ~~their efforts to educate/push-back~~'''=

='''EVALI outbreak — Consumer-led research, warnings, and pushback'''=

===Mysterious "vape" illnesses and THC cutting agents===

*When the news broke of vaping lung injuries, consumers started doing their own research, often discussing their findings in Facebook chat groups. Here are some of the compiled notes as they started looking for patterns that might indicate a cause.

Line 234:

Line 237:

*[https://docs.google.com/document/d/1BMqv26yghILkKpKf%20POhNKQfLV3qFn8JfPEQbBBJN84/edit?usp=sharing Mysterious Lung Issues]

*[https://docs.google.com/document/d/1KeEEsLg9spwI5UigtfYDQwzc8OINZyRkdIBJaFKSvOE/edit?usp=sharing MN, WI, TX, etc - illegal THC carts]

===~~"DANKing"~~ - ~~A new word~~ to ~~move the narrative where it belonged,~~ illicit ~~THR~~ carts~~, and away~~ from vaping ~~nicotine.~~===

===“DANKing” — A consumer-coined term to distinguish illicit THC carts from nicotine vaping===

*As the very real concern about the "vaping" illnesses and deaths spread, some states and cities moved quickly to ban nicotine vapes, or at least ban the flavors. They seemed to be unaware or ignored that it was unregulated THC products that were causing the outbreak. Consumers knew that the public needed an easy way to differentiate between THC and nicotine. Because so many illnesses were linked to a fake brand called "[https://www.wtvr.com/2019/09/27/in-lung-illness-outbreak-signs-point-to-majority-of-patients-vaping-thc-products Dank Vapes]," Andre Thov coined the term "DANKing." (See [https://www.facebook.com/share/p/1BNi6XLKdM/ comments] on this Facebook post.) Consumers began using the term on social media.

**Thov entered the term on [https://www.urbandictionary.com/define.php?term=Danking Urban Dictionary].

Line 241:

Line 244:

**[https://www.youtube.com/watch?v=exRRX0xrKvE Deadly Pesticides Found In Counterfeit Vaping Products | TODAY].

**Erin Mills, affiliated with PAVe (Parents Against Vaping e-cigarettes), [https://x.com/NYSMom4Kiddos/status/1171472581452419072 tweeted #danking].

**A 2019 webpage titled “FAQs about the vaping lung illness epidemic” on VapingHealthRisk.com used the term “danking” in reference to THC or marijuana vaping products. The page is no longer available at its original URL; a current attempt to access it returns a 502 Bad Gateway error. The original URL was: https://vapinghealthrisk.com/faqs-about-the-vaping-lung-illness-epidemic/. ~~The screenshoted~~ FAQ text reads: "Are vaping THC or marijuana (aka danking) products worse than nicotine e-cigarettes? Maybe. It appears as if THC and marijuana-related vaping or e-cigarette products may increase the risk of vaping lung diseases. The CDC reports the following usage patterns in the 30 days prior to becoming sick:" (the screenshot does not include the list)

**A 2019 webpage titled “FAQs about the vaping lung illness epidemic” on VapingHealthRisk.com used the term “danking” in reference to THC or marijuana vaping products. The page is no longer available at its original URL; a current attempt to access it returns a 502 Bad Gateway error. The original URL was: https://vapinghealthrisk.com/faqs-about-the-vaping-lung-illness-epidemic/. A screenshot of the FAQ text reads: "Are vaping THC or marijuana (aka danking) products worse than nicotine e-cigarettes? Maybe. It appears as if THC and marijuana-related vaping or e-cigarette products may increase the risk of vaping lung diseases. The CDC reports the following usage patterns in the 30 days prior to becoming sick:" (the screenshot does not include the list)

*Dray Moorman, who is both a consumer and a small business advocate, used the term in an Op-Ed published by NEWSMAX: [https://www.newsmax.com/newsfront/vape-vote-vaping-voters-trump/2019/10/11/id/936690/ Dray Moorman: Vape Vote Could Outweigh Impeachment Damage in 2020]. In part, it said: "Smoking black market oil is called danking. THC oil made in a drug dealer’s kitchen has nothing to do with e-cigs. Yet, opportunists and mainstream media are exploiting tragedy to attack vaping. And by doing so, they may be trying to force President Trump to alienate 12 million voters."

*Did those consumers have a lasting impact? While it was a thrill to have an influence on the narrative, most of them felt it wasn't big enough. But, perhaps, it was bigger than they thought. A 2025 WRTV Indianapolis article suggested the term may have had more staying power than consumers realized. In [https://www.wrtv.com/news/local-news/vape-shop-owner-shares-tips-to-avoid-black-market-products Vape shop owner shares tips to avoid black market products], Eskenazi Health Pulmonary Physician Graham Carlos said health officials haven't seen incidents like this since 2019. "People were what's called 'dabbing and danking.' That's when you add things to the pens and there was no regulation,"

<br>

[[File:Danking Today.png|center]]

~~<br>~~

===Ongoing misinformation and loss of trust===

Consumers are still struggling to trust the CDC. They are left wondering why it was they who had to take to social media to warn the public about the danger of unregulated THC carts cut with vitamin E acetate. They are also left wondering why vape shops had to tell customers that their cannabis use was their own business, but that until things got sorted out, they should smoke cannabis instead of vaping it. Why were consumers and shops quicker at getting the word out than the CDC? Those consumers are left wondering if that was the right time for the CDC to practice the "precautionary principle?"

To this day, consumers and academics use up considerable amounts of their free time, pushing back against misinformation that is keeping some people trapped in smoking tobacco. "EVALI" is still something weaponized, fueling a moral panic about nicotine vaping, and encouraging policymakers to raise taxes and/or ban the products. The CDC's lack of urgency in addressing the source of the misinformation means the word "EVALI" keeps consumers from trusting anything the CDC says.

='''Suggestions to add to this page'''=

@@ Line 5: / Line 5: @@
 <br>
 <br>
-The 2019–2020 outbreak of acute lung injuries in the United States represents a pivotal juncture in modern public health communication. Designated by the Centers for Disease Control and Prevention (CDC) as EVALI (“E-cigarette, or Vaping, Product Use-Associated Lung Injury”), the nomenclature explicitly embeds commercial electronic nicotine delivery systems (ENDS) into the medical definition of the disease. This was maintained despite clinical, laboratory, and epidemiological evidence identifying vitamin E acetate in illicit, unregulated tetrahydrocannabinol (THC) cartridges—not standard nicotine e-liquids—as the demonstrated cause of the outbreak.
+The 2019–2020 outbreak of acute lung injuries in the United States was real. The name given to it was the problem.
+The Centers for Disease Control and Prevention (CDC) named the outbreak “E-cigarette, or Vaping, Product Use-Associated Lung Injury,” or EVALI. That name embedded e-cigarettes and vaping into the medical language of the outbreak, even as clinical, laboratory, and epidemiological evidence increasingly pointed to vitamin E acetate in illicit, unregulated THC cartridges, not standard nicotine e-cigarettes.
-This page compiles empirical journal data, formal policy critiques, and contemporary media analysis documenting how the "EVALI" designation generated an unprecedented public health information shock. By conflating distinct product categories, this nomenclature distorted risk perceptions globally. It led a majority of adult smokers and youth to mistakenly believe that regulated nicotine vaping was the cause of the injuries. Consequently, peer-reviewed economic and behavioral data demonstrate that this ongoing institutional misclassification severely disrupted tobacco harm-reduction efforts, suppressed e-cigarette demand for smoking cessation, and inadvertently drove a resurgence in combustible tobacco consumption.
+The harm from the name “EVALI” did not end when the outbreak ended. By conflating nicotine vapor products with illicit THC cartridges, public health messaging distorted risk perceptions, contributed to widespread misunderstanding, and left many people believing that regulated nicotine vaping caused the injuries. That confusion affected many people. People who had switched from combustible tobacco to nicotine vaping went back to smoking. Some people who smoked tobacco became leery of switching. People using unregulated THC carts may not have recognized quickly enough that the warnings applied to the products they were using. With better messaging, some of the illnesses and deaths might have been averted.
+This page documents efforts to get the CDC to correct that name, the consequences of leaving it unchanged, the scientific evidence identifying the source of the outbreak, and the people who tried to correct the record in real time. It does this by bringing together journal articles, formal policy critiques, media analysis, public health statements, and consumer-led documentation to show how one imprecise name became a lasting public health communication failure.
 <br>
 <br>
@@ Line 228: / Line 231: @@
 **Citation: Betuel, E. (2019, September 13). A thickener used in pot vaping is a hugely popular black-market scam. Inverse. Retrieved June 6, 2026.
-='''EVALI outbreak - THC vaping research notes compiled by people who vape, and their efforts to educate/push-back'''=
+='''EVALI outbreak — Consumer-led research, warnings, and pushback'''=
 ===Mysterious "vape" illnesses and THC cutting agents===
 *When the news broke of vaping lung injuries, consumers started doing their own research, often discussing their findings in Facebook chat groups. Here are some of the compiled notes as they started looking for patterns that might indicate a cause.
@@ Line 234: / Line 237: @@
 *[https://docs.google.com/document/d/1BMqv26yghILkKpKf%20POhNKQfLV3qFn8JfPEQbBBJN84/edit?usp=sharing Mysterious Lung Issues]
 *[https://docs.google.com/document/d/1KeEEsLg9spwI5UigtfYDQwzc8OINZyRkdIBJaFKSvOE/edit?usp=sharing MN, WI, TX, etc - illegal THC carts]
-==="DANKing" - A new word to move the narrative where it belonged, illicit THR carts, and away from vaping nicotine.===
+===“DANKing” — A consumer-coined term to distinguish illicit THC carts from nicotine vaping===
 *As the very real concern about the "vaping" illnesses and deaths spread, some states and cities moved quickly to ban nicotine vapes, or at least ban the flavors. They seemed to be unaware or ignored that it was unregulated THC products that were causing the outbreak. Consumers knew that the public needed an easy way to differentiate between THC and nicotine. Because so many illnesses were linked to a fake brand called "[https://www.wtvr.com/2019/09/27/in-lung-illness-outbreak-signs-point-to-majority-of-patients-vaping-thc-products Dank Vapes]," Andre Thov coined the term "DANKing." (See [https://www.facebook.com/share/p/1BNi6XLKdM/ comments] on this Facebook post.) Consumers began using the term on social media.
 **Thov entered the term on [https://www.urbandictionary.com/define.php?term=Danking Urban Dictionary].
@@ Line 241: / Line 244: @@
 **[https://www.youtube.com/watch?v=exRRX0xrKvE Deadly Pesticides Found In Counterfeit Vaping Products | TODAY].
 **Erin Mills, affiliated with PAVe (Parents Against Vaping e-cigarettes), [https://x.com/NYSMom4Kiddos/status/1171472581452419072 tweeted #danking].
-**A 2019 webpage titled “FAQs about the vaping lung illness epidemic” on VapingHealthRisk.com used the term “danking” in reference to THC or marijuana vaping products. The page is no longer available at its original URL; a current attempt to access it returns a 502 Bad Gateway error. The original URL was: https://vapinghealthrisk.com/faqs-about-the-vaping-lung-illness-epidemic/. The screenshoted FAQ text reads: "Are vaping THC or marijuana (aka danking) products worse than nicotine e-cigarettes? Maybe. It appears as if THC and marijuana-related vaping or e-cigarette products may increase the risk of vaping lung diseases. The CDC reports the following usage patterns in the 30 days prior to becoming sick:" (the screenshot does not include the list)
+**A 2019 webpage titled “FAQs about the vaping lung illness epidemic” on VapingHealthRisk.com used the term “danking” in reference to THC or marijuana vaping products. The page is no longer available at its original URL; a current attempt to access it returns a 502 Bad Gateway error. The original URL was: https://vapinghealthrisk.com/faqs-about-the-vaping-lung-illness-epidemic/. A screenshot of the FAQ text reads: "Are vaping THC or marijuana (aka danking) products worse than nicotine e-cigarettes? Maybe. It appears as if THC and marijuana-related vaping or e-cigarette products may increase the risk of vaping lung diseases. The CDC reports the following usage patterns in the 30 days prior to becoming sick:" (the screenshot does not include the list)
 *Dray Moorman, who is both a consumer and a small business advocate, used the term in an Op-Ed published by NEWSMAX: [https://www.newsmax.com/newsfront/vape-vote-vaping-voters-trump/2019/10/11/id/936690/ Dray Moorman: Vape Vote Could Outweigh Impeachment Damage in 2020]. In part, it said: "Smoking black market oil is called danking. THC oil made in a drug dealer’s kitchen has nothing to do with e-cigs. Yet, opportunists and mainstream media are exploiting tragedy to attack vaping. And by doing so, they may be trying to force President Trump to alienate 12 million voters."
+*Did those consumers have a lasting impact? While it was a thrill to have an influence on the narrative, most of them felt it wasn't big enough. But, perhaps, it was bigger than they thought. A 2025 WRTV Indianapolis article suggested the term may have had more staying power than consumers realized. In [https://www.wrtv.com/news/local-news/vape-shop-owner-shares-tips-to-avoid-black-market-products Vape shop owner shares tips to avoid black market products], Eskenazi Health Pulmonary Physician Graham Carlos said health officials haven't seen incidents like this since 2019. "People were what's called 'dabbing and danking.' That's when you add things to the pens and there was no regulation,"
 <br>
 [[File:Danking Today.png|center]]
-<br>
+===Ongoing misinformation and loss of trust===
+Consumers are still struggling to trust the CDC. They are left wondering why it was they who had to take to social media to warn the public about the danger of unregulated THC carts cut with vitamin E acetate. They are also left wondering why vape shops had to tell customers that their cannabis use was their own business, but that until things got sorted out, they should smoke cannabis instead of vaping it. Why were consumers and shops quicker at getting the word out than the CDC? Those consumers are left wondering if that was the right time for the CDC to practice the "precautionary principle?"
+To this day, consumers and academics use up considerable amounts of their free time, pushing back against misinformation that is keeping some people trapped in smoking tobacco. "EVALI" is still something weaponized, fueling a moral panic about nicotine vaping, and encouraging policymakers to raise taxes and/or ban the products. The CDC's lack of urgency in addressing the source of the misinformation means the word "EVALI" keeps consumers from trusting anything the CDC says.
 ='''Suggestions to add to this page'''=