CBD Oil and Vitamin E Acetate in Vaping Products Adhered to and Damaged Human Airway Cells in Lab Tests | Research

The takeaway

When human bronchial epithelial cells were exposed to CBD oil and vitamin E acetate aerosols in the lab, both substances adhered to airway surfaces and accumulated inside cells, causing dramatically increased cell death and markers of metabolic stress.

Pulmonologists, vaping safety researchers, public health officials, cannabis consumers who vape.

CBD oil aerosol caused dramatic cell death in human airway cells after 3 days

What the researchers found

CBD oil exposure caused dramatically increased cell death after 3 days, and this effect was even higher with CBD + vitamin E acetate (VEA) combined. Microscopy revealed cannabinoid and VEA deposits on epithelial surfaces and cannabinoid accumulation inside cells. Proteomic analysis showed increases in xenobiotic enzymes, oxidative stress markers, and cell death indicators.

Why it matters

The 2019 EVALI outbreak hospitalized thousands of young people, and the CDC linked it to vitamin E acetate in cannabis vaping products. This study provides a cellular mechanism showing how these substances physically damage airway cells.

The numbers in context

Cell death dramatically increased after 3 days of CBD exposure. CBD + VEA exposure caused even greater cell death. Proteomic analysis identified increased xenobiotic enzymes, oxidative stress markers, and cell death indicators.

How the study worked

Primary human bronchial epithelial cell cultures exposed to e-liquid aerosols containing CBD oil and VEA alone or combined, with PG/VG (with and without nicotine) as controls. Cell viability, microscopy, and proteomic analysis.

What this study cannot tell us

In vitro cell culture model does not fully replicate in vivo lung conditions. Exposure durations and concentrations may not match real-world vaping patterns. Did not test THC oil, only CBD oil. Limited to short-term effects.

How to read the evidence

In vitro lab study using primary human cells. Provides mechanistic insight but results require in vivo validation.

When this study was published

Published in 2023.

The bigger picture

While the EVALI crisis largely subsided after vitamin E acetate was identified and removed from most products, unregulated cannabis vaping products remain widely available. Understanding exactly how these additives damage lungs helps inform both regulation and clinical treatment.

Questions still open

Do these findings apply equally to THC oil vaping products?
What concentration threshold triggers significant airway damage?

Common questions

Is vaping CBD oil harmful to the lungs?

In this lab study, CBD oil aerosol adhered to and accumulated inside human airway cells, causing significant cell death and metabolic stress markers after just 3 days of exposure.

What role did vitamin E acetate play in lung damage?

Vitamin E acetate combined with CBD oil caused even greater cell death than CBD oil alone. Both substances deposited on airway surfaces and were taken up by cells.

Read the original research

Vaping additives cannabinoid oil and vitamin E acetate adhere to and damage the human airway epithelium.

Journal of applied toxicology : JAT, 43(5), 680-693

View on PubMed ↗Publisher’s paper ↗

Citation

Reidel, Boris; Abdelwahab, Sabri; Wrennall, Joe Alexander; Clapp, Phillip W; Beers, Jessica L; Jackson, Klarissa D; Tarran, Robert; Kesimer, Mehmet. (2023). Vaping additives cannabinoid oil and vitamin E acetate adhere to and damage the human airway epithelium.. Journal of applied toxicology : JAT, 43(5), 680-693. https://doi.org/10.1002/jat.4415