Illustration: Sarah Grillo/Axios

A mysterious vaping-related lung illness has now afflicted more than 1,000 people and killed at least 21 — and America's patchwork approach to marijuana law is probably part of the problem.

The big picture: Most of these lung illness cases involve people who vaped THC, the primary psychoactive ingredient in marijuana, and many of those pods are believed to have come from the black market. A more cohesive regulatory scheme could help consumers know what to trust.

Health officials don't know yet whether the culprit is the liquids being vaped, their interaction with the vape pen materials, or a combination of the two. But legal, regulated products used as directed don't seem to be the primary cause.

  • Juul, for example, neither makes THC vape pods nor intends them to be used in their devices.

Where it stands: THC is a Schedule 1 drug under federal law., severely restricting scientists' and regulators' ability to study its effects.

  • But THC is legal in more than a dozen states, thanks to marijuana legalization efforts.
  • Few of those states, though, require stringent oversight of THC-specific products such as vape pods.
  • "State laws that have loosened access to cannabinoids have come at a public health cost," said former Food and Drug Administration Commissioner Scott Gottlieb.

"Ultimately, a federal regime could make it easier to access cannabis for conducting proper studies ... At the same time, a federal regime should tighten permissive state practices that have made it far too easy for recreational marijuana to gain acceptance and for these compounds to get into the hands of kids," he added.

Yes, but: At least a few patients afflicted by the lung illness claim to have only vaped nicotine.

  • And research this week from New York University found that vaping nicotine caused lung cancer in mice, per CNBC. The researchers said vaping is likely “very harmful” to humans as well.

The bottom line: Traditional vaping gets people hooked on nicotine, and kids and teens have proven particularly vulnerable. It deserves political attention.

  • But so does an inconsistent regulatory framework that is contributing to serious, immediate dangers.

Go deeper: Special report: Weed, Inc.

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