Vitamins are not for vaping

Vaping products and e-cigarettes are fairly new technologies for drug delivery: the first commercially successful product is attributed to a Chinese pharmacist back in 2003. Introduced in Europe and the United States in 2006, they have been widely available worldwide for just over a decade. In many countries, e-cigarettes are a technology that occupy a “grey zone” where they are regulated differently than cigarettes. The main components (a battery, a heating element, and a vaporizing liquid), are most commonly used to deliver nicotine, so the products can be used as cigarette substitutes. The evidence that these products are effective smoking cessation products is modest but seems real. But the devices can be used to deliver almost any substance into the lungs. The biggest growth area for e-cigarette use over the past several years has been youth and young adults, in part through the sale of novelty- and candy-flavoured vape liquids that can also deliver concentrated nicotine doses.

Perhaps not surprisingly, some enterprising businesses have begun incorporating vitamins into vape liquids, trying to build on the novelty of vaping along with the possible health halo from those that see vaping as a healthier alternative to smoking. There are many reasons why this is a terrible idea.

The claims

VitaStick sells a cigarette-shaped “essential oil aromatherapy dispenser” with products containing four vitamins (C, B2, B6, and B12) along with herbs (e.g., valerian) and hormones (e.g., melatonin). They claim “inhaling=ingesting” and that their products are food-grade. They also claim that you can safely vaporize their products, including the vitamins.

Breathe sells B12 “diffuser kits” that deliver 5,000% of your daily needs with one dose. Their product is very similar to VitaminVape which also sells B12 vapes (they even show the same picture of a factory as Breathe). VitaCig apparently contains fruit juices along with vitamins A, B2, B6 and B12. Some versions contain stimulants like caffeine and herbs like ginseng and gingko biloba. They claim their products are “safe to use” but no evidence of safety testing is presented.

The evidence

While all of the products I examined above go to great lengths to position their products as “healthy”, none provided any information or actual data that showed their products had been tested and been found to be safe or effective. Some contain other chemicals (e.g., propylene glycol, glycerine) in addition to essential oils and vitamins. There is no published evidence showing that any of these ingredients can be safely vaped – or that the vaporization process doesn’t degrade the vitamins completely.

It also goes without saying that we did not evolve to get our vitamins by inhalation, but via our gastrointestinal tract. The best sources of vitamins are food and a balanced diet obviates the need for vitamin supplements in most cases – for most people, vitamin supplementation is unnecessary. When supplements are advisable, they are almost always supplied orally. In rare circumstances, injectable vitamins may be necessary. There is no medical case for inhaled vitamins.

What is EVALI?

E-cigarette or vaping product use associated lung injury (EVALI) was first described a few years ago as a respiratory illness that can be life-threatening. It is a form of acute lung injury where the key risk factor in the thousands of cases reported is an e-cigarette. Tetrahydrocannabinol (THC) and vitamin E acetate have been linked to most of the reported cases, but nicotine, cannabinoid (CBD) oil, and other substances have also been attributed to EVALI. Most cases require hospitalization and some even case, mechanical ventilation. Given how little is known about EVALI, and the severity of the illness, the Centers for Disease Control has recommended avoidance of e-cigarettes and vaping.

The FDA responds

The FDA is warning consumer and cracking down on manufacturers who sell vitamin vapes. They note,

Some vaping products are being illegally offered for sale with unproven health or wellness claims, including improving mental clarity or treating tumors or asthma. Some examples of these companies’ fraudulent product claims are:

• “Fight off tumors and alleviate symptoms of chemotherapy!”
• “It’s been used as a [sic] organic asthma remedy, ADHD remedy, and dementia treatment.”
• “Helps prevent a type of anemia called megaloblastic anemia that makes people tired and weak.”
• “Neroli oil… has long been used as a treatment against anxiety and depression, to calm the mind and soothe away tension.”

These claims are unproven, and the products may be ineffective, a waste of money, unsafe, and may prevent or delay you from seeking an appropriate diagnosis and treatment from a health care professional.

Risks from inhaled products
In addition to unproven health claims, these vaping products may present other risks. Inhaled products can be dangerous and even may trigger severe coughing, cause airway tightening, and make speaking and breathing difficult. Also, there’s no way to know if these “wellness” vaping products contain ingredients or impurities that may cause or make these symptoms worse, or cause permanent damage, such as bronchiolitis obliterans (also called popcorn lung).

The FDA sent a number of warning letters to manufacturers of these products in December 2021. They are describing these products as unapproved drugs:

Your Caffeine Pen products are not generally recognized as safe and effective for the above referenced uses and, therefore, these products are “new drugs” under section 201(p) of the FD&C Act, 21 U.S.C. 321(p). With certain exceptions not applicable here, new drugs may not be legally introduced or delivered for introduction into interstate commerce without prior approval from FDA, as described in sections 301(d) and 505(a) of the FD&C Act, 21 U.S.C. 331(d) and 355(a). FDA approves a new drug on the basis of scientific data submitted by a drug sponsor to demonstrate that the drug is safe and effective. No approved applications are in effect for your products.

For the love of all things that are holy, don’t vape your vitamins

There is zero biochemical logic to inhaling vaporized vitamins. We all evolved an unbelievably efficient gastrointestinal tract that effectively extracts what we need from the foods that we eat. Eat a balanced diet and you probably won’t ever need to take a vitamin. If you do need to take vitamins, oral supplements are cheap, efficient, effective, and generally safe. None of that can be said for vaping vitamins.