A few years after a nationwide outbreak of vaping-related lung illnesses linked to counterfeit cannabis products between 2018 and 2020, young adults on TikTok have recently dubbed this the cartdemic phenomenon, sparking new discussions about the effects of unregulated vapes and THC cartridges.
In May 2023, thousands of users on TikTok began posting about the cartdemic, creating memes and video trends shedding light on the effects of using unregulated THC cartridges or carts. A large portion of these users claim these carts have caused long-term cognitive side effects such as slowed speech, memory loss, and impaired language processing abilities.
Understanding the 2019-2020 Vaping Lung Illness Outbreak
Between April and September 2019, thousands of teens and adults across the country were hospitalized for e-cigarette, or vaping, product use-associated lung injury (EVALI). EVALI is used to describe a variety of lung injuries associated with the use of vaping products, and its symptoms may sometimes be mistaken for other common lung conditions like pneumonia.
Symptoms of EVALI may present over days or weeks. According to the San Francisco Department of Public Health, symptoms of EVALI may include the following:
- Shortness of breath
- Chest pain
- Cough
- Fatigue, dizziness
- Body aches
- Fever or chills
- Nausea, abdominal pain
- Vomiting, diarrhea
As of February 2020, more than 2,800 EVALI cases—including over 60 deaths—were reported across the U. S., according to the Centers for Disease Control and Prevention (CDC). Of those cases, 15% were under 18 years old, and 37% were between 18 and 24 years old. In other words, more than half of EVALI cases were individuals under 25.
EVALI cases peaked in September 2019, and by February 2020, hospitalizations and emergency room visits had declined considerably. The CDC said this decline may be attributed to increased response from health professionals, public awareness, law enforcement action, and removing vitamin E acetate from the carts.
How Did the Cartdemic Happen?
While the U.S. Food and Drug Administration (FDA) regulates products containing nicotine, vape products have not been approved for sale by the FDA. On the other hand, THC products are still federally illegal but are allowed and regulated at the state level.
As states began legalizing and decriminalizing cannabis and demand increased in recent years, illicit dealers began diluting THC concentrations in their products with vitamin E acetate. According to the CDC, vitamin E acetate is safe when ingested or applied to the skin but may interfere with lung functioning when inhaled.
The majority of those treated for EVALI reported using illicit cannabis carts and vape products, and more than half of them also reported using nicotine products.
The CDC determined the 2019 outbreak of EVALI cases was linked to THC products containing vitamin E acetate. However, they also said more evidence is necessary to rule out whether other chemicals in THC and nicotine products contributed to EVALI cases.
TikTok’s Role in the Cartdemic Conversation
Like the COVID-19 pandemic, after which it was seemingly nicknamed, the cartdemic appeared to be a past phenomenon. But now, years later, it has emerged as a trending topic on social media as young people and Gen Z’ers on TikTok last spring started posting about their experiences using illicit THC carts.
Many teens and young adults on social media reported believing the cartdemic affected their speech, intelligence, and social skills after using unregulated carts as adolescents.
“When people think I’m too pretty to be so stupid but I was a survivor of the cartdemic and just can’t turn my thoughts into words. So I always sound like I don’t even know what I’m saying,” one young adult joked on TikTok.
The post now has 2.1 million views and over 260,000 likes, and many users commented with similar experiences.
“I literally have like the most intellectual thoughts and conversations in my head, but I can never vocalize them,” one user commented.
“When someone’s trying to talk to me but the cartdemic hit me so hard all I do is stutter and make obscure comments,” another TikToker posted.
Counterfeit THC Cart Packaging Targets Teens
Many counterfeit THC cartridges were marketed toward young adults and teens using cartoon and pop culture-themed packaging. Some users posted TikTok videos about their disbelief at how easy it now is to identify a counterfeit or fake THC cart, though a few years ago, they may not have been as wise.
“Personally, I was heavily victimized and I have no idea what was going on in 16-year-old Ryan’s head when he saw the Apple Jacks logo on a box and was like, ‘Oh my god, like the dream collab, obviously Apple Jacks [and] Dank Vape is going to work together,” a TikTok user said.
“Or when I knew these were completely safe and not sketchy at all because it said clean and tested on the box,” the TikToker said, referencing a picture of two Royal Oil carts with “clean and tested” written cartoon-like font on the boxes.
The user went on to say he believes vaping fake cannabis cartridges affected his memory.
“But as a result, I only have three memories from my junior year of high school. That’s it,” he said.
The video, which was posted in January, now has over 200,000 likes and more than 3,500 comments, most of which are from other young adults talking about their experience with using THC carts. Many TikTok users commented on the video with similar stories.
“I have no memories from before 2020 and it’s INSANE,” one user said.
“Currently in the cartdemic and can feel my brain smoothing over,” another user shared.
Like this user, many adolescents and young adults commented on the video claiming that the cartdemic is “still in effect.”
Young Adults’ Perspectives: Is the Cartdemic Still Happening?
Often regarded for their ironic and dark style of humor, Gen Z is among the majority of users on TikTok joking about the cartdemic, likely as a means of coping with not knowing how the undisclosed chemicals from nicotine or cannabis vapes may affect their health later in life.
Additionally, it is still unclear whether THC-containing products and vapes being sold across the country are any safer now than they were five years ago. A handful of users commented on TikTok videos about the cartdemic, claiming that fake THC cartridges are still an issue.
At the peak of the cartdemic in 2019, some of the most popular counterfeit THC cartridge brands included Dank Vapes, TKO, Rove, and Chronic Carts, but social media users claim the contents have not changed, just the brand names and packages.
“The cartdemic has not ended but evolved into Packmans and FRYDs,” one user commented on a video. Both Packman and FRYD are THC vape brands that have been widely discussed on social media for the safety of their contents and the legitimacy of products sold under their names.
“I’m in my cartdemic [right now],” another user said in a comment, which received almost 30,000 likes and over 100 replies from other users saying they still use THC carts.
In states where cannabis is illegal but the law is vague around other hemp derivatives, vape, and smoke shops may sell products that contain alternative forms of THC, like delta-8. The use of delta-8 products has become increasingly popular among high school- and college-aged individuals since 2021 and 2022.
Impact of TikTok on Public Awareness and Change
TikTok has become popular over the last few years because of its For You Page algorithm. TikTok’s algorithm tailors users’ For You Pages (FYPs) based on their preferences, indicated by past and current activity. In other words, the platform learns about users in real time based on the content and accounts they interact with.
On TikTok, when a sound byte or audio clip begins to trend, the platform’s algorithm directs more content dubbed with that sound to users’ FYPs. Though some TikTokers use trending audio clips to create fun and humorous content, others may use these sounds and the attention they attract to inform or build awareness around other conversations or issues, like the cartdemic.
TikTok’s FYP has granted exposure and awareness to endless topics, hobbies, and communities worldwide. With over 100 million global users, the platform provides a communal space for users to share their interests and experiences, whether they be victims of the cartdemic, ex-Evangelicals, or even recovering addicts, for example.
Leaders in Substance Abuse and Mental Health
Many young people consider cannabis safer and less addictive than alcohol or other drugs. However, marijuana is often used to combat symptoms of underlying mental health conditions, which can lead to problematic use or addiction.
If you or a loved one are struggling with cannabis addiction, substance abuse, or mental health disorders, feel free to reach out to us at The Summit Wellness Group to learn more about our services and treatment programs. Reach us at (770) 796-3304 or ContactUs@TheSummitWellnessGroup.org.