Health officials have identified the likely cause of a series of vaping-related injuries and deaths recently reported in the US. Tests were carried out on lung fluids of 29 people who fell ill during a dangerous outbreak of respiratory-injuries linked to e-cigarettes. Although the presence of other harmful compounds were also identified in the investigation, scientists are confident vitamin E acetate contributed to the hospitalisation of more than 2,000 vapers and 39 deaths. The US Centres for Disease Control and Prevention found ‘direct evidence’ of the compound at the primary site of lung injury in each of the patients tested. “The latest information points to growing evidence of vitamin E acetate as a very strong culprit of concern,” said Anne Schuchat, principal deputy director at the CDCP, in a US news briefing. “The findings are significant because for the first time, we have been able to connect results from product testing with clinical specimens from patients.” Researchers reported no other potential toxins detected in the 29 lung samples, describing the study as a ‘breakthrough’ in the investigation to understand more about the recent spate of vaping related deaths. Most of those who fell ill admitted vaping tetrahydrocannabinol (THC), the psychoactive ingredient found in marijuana. Of the lung fluid samples from 29 patients across 10 US states examined by CDCP scientists, 23 contained THC and 16 had traces of nicotine. Vitamin E acetate is a colourless ingredient with no smell that can be hard to detect. It is often used as a thickening agent in e-cigarettes and vaping liquids and in other illegal substances like cannabis. The substance has a similar viscosity to THC oil, but is considerably cheaper and potentially lethal. Vitamin E itself is found in many foods, including vegetable oils, cereals, meat, fruits, and vegetables and is available as a dietary supplement and skin creams. Although usually harmless when ingested as a vitamin supplement or applied to the skin, research suggests it may interfere with normal lung function when inhaled. Many of those who fell ill said they purchased their vaping devices on the black market. As of November 5, US authorities have reported 2,051 lung injuries related to vaping or e-cigarettes across 49 states. The average age of the deceased was 53, with 79 per cent under 35 and 70 per cent men. About 86 per cent of those with lung injuries reported using THC-containing products, with 34 per cent admitting exclusive use of THC. Researchers found it difficult to identify a specific vaping product, as users reported a wide range of brands and substances. The sale of e-cigarettes were banned in the UAE until April when new regulation on the sale of registered products opened the door for a new market in the country. The tobacco industry has recently launched heat-not-burn tobacco products on sale in the UAE. Battery operated gadgets, such as the Philip Morris International iQos and Glo from British American Tobacco, heats tobacco at a lower temperature than combustible cigarettes, emitting fewer toxic chemicals. Dubai World Trade is due to host the region’s largest vaping expo in June 2020. Meanwhile, doctors in the UAE have condemned the use of e-cigarettes by children and called for a ban on flavoured products that may encourage youngsters to vape. “E-cigarettes have become an easy, legal device where people can mix substances with nicotine liquids for an additional hit,” said Dr Fadi Baladi, medical director at Burjeel Day Surgery Centre in Abu Dhabi. “This is causing serious health problems.”