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despite this, it has been used as an additive to dilute the THC in e-cigarettes/vapes.2 3 A lesser discussed yet also prevalent agent is medium chain triglycerides (MCT), present in almost 20% of studied vaping cartridges.4 MCT was historically used as a nutraceutical oil due to its health benefits as a replacement for traditional oils in cooking.5 Its addition to vaping mixtures is similar to VEA since it helps dilute or concentrate the mixtures and acts as a medium to aerosolise the liquid.6 This process, much like with VEA, also has the potential to result in lung injury from its interaction with pulmonary surfactant, although, like VEA, the exact process requires further study.6 Currently, the CDC and FDA warn against the use of any THC e-cigarette products with VEA and of the potential dangers of MCTs.4 Additionally, while the risk may not be as high, conventional nicotine-containing products (without THC) have also been reported to cause vaping associated acute lung injury (EVALI)

The original cowboys came into the American West from Mexico as early as the 18th century