Myth: Vaping causes Popcorn Lung: Difference between revisions

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=What is Popcorn Lung?=
=What is Popcorn Lung?=
The technical term for this illness is Bronchiolitis obliterans. It can be referred to as obliterative bronchiolitis or bronchiolitis obliterans syndrome. It has also been called “[https://www.sciencedirect.com/science/article/pii/S2352396423003250 Silo-fillers Lung]” due to people becoming ill after breathing the gasses from sillage.


=What causes Popcorn Lung?=
Bronchiolitis obliterans is a rare lung condition that affects the small airways, blocking air movement by causing constriction and scarring.
 
Most patients with Bronchiolitis obliterans are treated with medications and therapy by a [https://www.ncbi.nlm.nih.gov/books/NBK441865/ multidisciplinary team.]Those patients will experience a poor quality of life, and the majority of them will die prematurely from respiratory failure.
 
=What causes Popcorn Lung / Bronchiolitis Obliterans?=
 
Bronchiolitis obliterans is rare. It was first [https://www.ajronline.org/doi/epdf/10.2214/ajr.117.4.816 mentioned] in 1835, and it was not until [https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(23)00325-0/fulltext 1901] that it was mentioned again in medical writings. At that time, inhalation of toxic fumes or foreign bodies and respiratory infections were attributed to causing Bronchiolitis obliterans.
 
Bronchiolitis obliterans syndrome afflicts about 50% of [https://www.atsjournals.org/doi/full/10.1164/rccm.200201-003PP lung transplant patients] within [https://www.jhltonline.org/article/S1053-2498(16)30300-X/fulltext five years] and 2% - 6% of [https://www.sciencedirect.com/science/article/pii/S1083879109005199 hematopoietic stem cell] transplantation patients. Some patients with autoimmune diseases are prone to it, too.
 
Bronchiolitis obliterans can occur after chemical agent exposure, which has been an occupational hazard in agriculture and manufacturing. It has affected workers who make [https://www.nejm.org/doi/full/10.1056/NEJMoa020300 microwave popcorn,][https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4715657/ coffee,]flavorings, etc. It has been found in employees of [https://haz-map.com/Diseases/551 textile] and other industries. Veterans exposed to gasses and [https://www.woodslawyers.com/constrictive-bronchiolitis-va-disability-rating/ burn pits,]along with people [https://www.nyc.gov/html/doh/wtc/downloads/pdf/studies/medgroup-report-joem.pdf exposed] to the dust and fumes from the [https://onlinelibrary.wiley.com/doi/10.1002/ajim.20196 collapse] of the World Trade Center, have also experienced bronchiolitis obliterans. Some viral infections can cause bronchiolitis obliterans.


=If it has a scientific name, why is it called Popcorn Lung?=
=If it has a scientific name, why is it called Popcorn Lung?=
From the [https://www.cdc.gov/os/wewerethere/diacetyl/index.html Centers for Disease Control and Prevention]: "In 2000, a physician reported that eight former microwave-popcorn factory workers had developed a rare and disabling lung disease, bronchiolitis obliterans. Four of the eight workers were ill and put on lung transplant waiting lists. After investigating numerous possible sources, researchers ultimately determined the cause of lung damage: a vapor from butter flavoring added to the popcorn."
Diacetyl is the [https://www.cdc.gov/niosh/topics/flavorings/default.html chemical] that gave the microwave popcorn its buttery flavor.
=How is bronchiolitis obliterans (Popcorn Lung) diagnosed?=
"If you have some of the symptoms of bronchiolitis obliterans, your doctor might recommend a computerized tomography (CT) scan of your chest. Several X-rays are taken from different angles and are put together to make a more complete picture. They'll probably also want to test how well your lungs are working.
A chest X-ray might tell your doctor if your lungs are holding in too much air, but '''<span style="background:#ffff00">the best way to confirm you have bronchiolitis obliterans is to have a biopsy.</span>''' This is most often done with surgery." [https://www.webmd.com/lung/popcorn-lung (Source WebMD)] (Emphasis added)


=Is Popcorn Lung the same thing as EVALI?=
=Is Popcorn Lung the same thing as EVALI?=
The two diseases are often conflated but are not the same.
While a variety of things can cause bronchiolitis obliterans (Popcorn Lung), it has been determined that E-cigarette, or Vaping, product use-Associated Lung Injury (EVALI) can be attributed to the addition of [https://www.leafly.com/news/health/vape-pen-lung-disease-vitamin-e-oil-explained Vitamin E]to make unregulated vape cartridges containing tetrahydrocannabinol (THC) from marijuana look thick and of higher quality. The additive was used for a brief period of time in 2019-2020. These [https://www.leafly.com/news/health/some-vape-cart-additive-makers-pull-products-others-go-dark thickeners] were pulled from the market by their manufacturers as news of the EVALI outbreak spread.
Nicotine [https://www.qeios.com/read/ZGVHM7.3 vapor] products did not cause EVALI. Leading experts [https://drive.google.com/file/d/1o0mlqZaMMUeD7Eapc1H0CdSsTz4HsuxE/view requested] the Centers for Disease Control and Prevention (CDC) change the name of EVALI to help consumers better understand the difference between vaping THC and nicotine. The CDC declined to make that change.


=Why are some experts claiming vaping causes Popcorn Lung?=
=Why are some experts claiming vaping causes Popcorn Lung?=
In 2015 the paper "[https://ehp.niehs.nih.gov/doi/10.1289/ehp.1510185 Flavoring Chemicals in E-Cigarettes: Diacetyl, 2,3-Pentanedione, and Acetoin in a Sample of 51 Products, Including Fruit-, Candy-, and Cocktail-Flavored E-Cigarettes]" was published. The authors found Diacetyl in some of the e-liquids they tested. They concluded, "Our findings confirm the presence of diacetyl and other flavoring chemicals in flavored e-cigarettes. Because of the associations between diacetyl and bronchiolitis obliterans and other severe respiratory diseases among workers inhaling heated vapors containing diacetyl, urgent action is recommended to further evaluate the extent of this new exposure to diacetyl and related flavoring compounds in e-cigarettes." {The vapors that workers inhaled were not vapor from an e-cigarette.)
In 2015 the paper "[https://ehp.niehs.nih.gov/doi/10.1289/ehp.1510185 Flavoring Chemicals in E-Cigarettes: Diacetyl, 2,3-Pentanedione, and Acetoin in a Sample of 51 Products, Including Fruit-, Candy-, and Cocktail-Flavored E-Cigarettes"]was published. The authors found Diacetyl in some of the e-liquids they tested. They concluded, "Our findings confirm the presence of diacetyl and other flavoring chemicals in flavored e-cigarettes. Because of the associations between diacetyl and bronchiolitis obliterans and other severe respiratory diseases among workers inhaling heated vapors containing diacetyl, urgent action is recommended to further evaluate the extent of this new exposure to diacetyl and related flavoring compounds in e-cigarettes." (The vapors that workers inhaled were not vapor from an e-cigarette.) [https://twitter.com/j_g_allen/status/1751230489615126963 Twitter thread about study.]
 
Harvard T.H. Chan School of Public Health issued a press release about the study, "[https://www.hsph.harvard.edu/news/press-releases/e-cigarette-flavoring-chemicals-linked-to-respiratory-disease/ Chemicals linked with severe respiratory disease found in common e-cigarette flavors"](Link saved on [https://web.archive.org/web/20151212202826/https://www.hsph.harvard.edu/news/press-releases/e-cigarette-flavoring-chemicals-linked-to-respiratory-disease/ Wayback Machine.)]While the safety of e-cigarettes does need to be monitored, the study and the press release did not compare the levels of the chemicals found to what is inhaled from smoking a combustible cigarette. Neither the paper nor the press release said people will get Popcorn Lung from vaping. They just raised concern about the possibility.
 
While Dr. Farsalinos is strongly opposed to the use of Diacetyl in e-liquids, he is [http://www.ecigarette-research.org/research/index.php/whats-new/whatsnew-2015/236-da2 concerned]about the study because "the article is creating false impressions and exaggerates the potential risk from diacetyl and acetyl propionyl exposure through e-cigarettes. They failed to mention that these chemicals are present in tobacco cigarette smoke and violated a classical toxicological principle that the amount determines the toxicity and the risk."
 
Dr. Brad Rodu has concerns about the methods used in this study and said in his [https://rodutobaccotruth.blogspot.com/2015/12/is-harvard-e-cigarette-buttery-flavor.html blog,]"As I advised previously, vapers should only use liquids that are certified to be free of buttery flavors that are suspected respiratory toxicants.  However, laboratory investigations of e-cigarettes should use validated methods to assure credibility. The results of the Harvard Buttery Flavor Study do not meet this standard."
 
Science writer Carrie Arnold [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892907/ commented]on this study and said, "This study did not assess levels of diacetyl, 2,3-pentanedione, and acetoin in actual users, much less health effects. So it’s premature to assume that exposure to these chemicals via e-cigarettes causes health problems."
 
The study and [https://www.vox.com/2015/12/9/9880926/e-cigarettes-popcorn-lung-harms alarm]over the [https://time.com/4139335/e-cigarettes-chemicals-diacetyl/ potential]danger of vaping made [https://tobaccoanalysis.blogspot.com/2015/12/new-study-finds-that-average-diacetyl.html headlines]across the US and [https://healingoracle.ch/2017/04/03/confirmed-e-cigarettes-cause-a-horrible-incurable-disease-called-popcorn-lung-worse-than-lung-cancer/ globally.]Most of the articles failed to mention there are [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892705/ more]of these chemicals in [https://erj.ersjournals.com/content/53/2/1801151 combustible cigarettes,]and there are no [https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/684963/Evidence_review_of_e-cigarettes_and_heated_tobacco_products_2018.pdf documented]cases of Popcorn Lung being caused by [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892932/ smoking]or [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693960/ vaping].


Harvard T.H. Chan School of Public Health issued a press release about the study, "[https://www.hsph.harvard.edu/news/press-releases/e-cigarette-flavoring-chemicals-linked-to-respiratory-disease/ Chemicals linked with severe respiratory disease found in common e-cigarette flavors] (Link saved on [https://web.archive.org/web/20151212202826/https://www.hsph.harvard.edu/news/press-releases/e-cigarette-flavoring-chemicals-linked-to-respiratory-disease/ Wayback Machine]). While the safety of e-cigarettes does need to be monitored, the study and the press release did not compare the levels of the chemicals found to what is inhaled from smoking a combustible cigarette. Neither the paper nor the press release said people will get Popcorn Lung from vaping. They just raised concern about the possibility.
A chemical of concern that might pose potential harm swiftly morphed into known harm, and word began to [https://us.blastingnews.com/opinion/2015/12/new-e-cig-study-reveals-crisis-in-journalism-00691827.html spread]that vaping causes Popcorn Lung, even though there were no documented cases of it actually occurring. A 2015 report published in the [https://www.jsonline.com/story/archives/2019/09/18/diacetyl-popcorn-lung-chemical-e-cigarettes-coffee-roasting-plants/2078765002/ Milwaukee Journal Sentinal]gave a historical run-down of cases of Popcorn Lung in the food industry and questioned why Diacetyl was allowed in e-cigarettes.  


The study and alarm over the potential danger of vaping made headlines across the US and globally. Most of the articles failed to mention there are more of these chemicals in combustible cigarettes, and there are no documented cases of Popcorn Lung being caused by smoking or vaping.  
The American Lung Association added [https://web.archive.org/web/20160709232304/http://www.lung.org/about-us/blog/2016/07/popcorn-lung-risk-ecigs.html information]about Popcorn Lung and vaping on their website in 2016, leading the public to believe that vaping causes Popcorn lung when there have been no biopsy confirmed cases that can be confirmed to be caused by vaping.  


A chemical of concern that might pose potential harm swiftly morphed into known harm, and word began to falsely spread that vaping causes Popcorn Lung. The American Lung Association put [https://web.archive.org/web/20160709232304/http://www.lung.org/about-us/blog/2016/07/popcorn-lung-risk-ecigs.html information] about Popcorn Lung and vaping on their website in 2016.
In 2018, [https://www.newyorker.com/magazine/2018/05/14/the-promise-of-vaping-and-the-rise-of-juul Jonathan Winickoff,]the former chair of the American Academy of Pediatrics Tobacco Consortium, a pediatrician at Massachusetts General Hospital and a professor at Harvard Medical School, said that he "believes that the vape industry is co-opting the national wellness trend—when, in fact, vaping can cause something called bronchiolitis obliterans, or popcorn lung."


In 2018, [https://www.newyorker.com/magazine/2018/05/14/the-promise-of-vaping-and-the-rise-of-juul Jonathan Winickoff], the former chair of the American Academy of Pediatrics Tobacco Consortium, a pediatrician at Massachusetts General Hospital and a professor at Harvard Medical School, said that he "believes that the vape industry is co-opting the national wellness trend—when, in fact, vaping can cause something called bronchiolitis obliterans, or popcorn lung."
Schools, in an [https://www.theedadvocate.org/teaching-students-about-popcorn-lungs-disease/ attempt]to keep teens safe and discourage them from experimenting with vaping began telling [https://web.archive.org/web/20200806010833/https://www.minnetonkabreezes.com/sports/2019/12/20/popcorn-lung/ students]they could get Popcorn Lung from vaping.


Schools, in an [https://www.theedadvocate.org/teaching-students-about-popcorn-lungs-disease/ attempt] to keep teens safe and discourage them from experimenting with vaping began telling [https://web.archive.org/web/20200806010833/https://www.minnetonkabreezes.com/sports/2019/12/20/popcorn-lung/ students] they could get Popcorn Lung from vaping.  
Misperceptions about the risk of getting Popcorn Lung from vaping can lead some people who smoke to [https://www.sciencedirect.com/science/article/pii/S0376871623000443 avoid]trying this safer alternative to help them quit smoking. A point that was made by Jennifer Pierce, Anders Abelmann, and Brent Finley in their [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892932/ commentary]about the 2015 flavoring study.


=What actions were taken to protect consumers after the study was released?=
=What actions were taken to protect consumers after the study was released?=
*Many e-liquid manufacturers switched to Diacetyl-free ingredients.
*Most flavor [https://shop.perfumersapprentice.com/t-FlavorWorkshopCustard.aspx manufacturers] reformulated their flavoring to [https://nicotineriver.com/collections/flavourart-concentrates Diacetyl-free] formulas.
*As a further precaution to avoid the potential for there to be an issue in the future, some countries have banned the use of Daicetyl in e-liquids. Examples include [https://www.legislation.gov.au/F2021L00595/latest/text Australia],[https://www.gov.uk/government/publications/chapter-6-ingredient-guidance-northern-ireland Northern Ireland], [https://www.gov.uk/government/publications/chapter-6-ingredient-guidance-great-britain Great Britain], and member states of the EU Tobacco Products Directive (TPD).
*A [https://www.frontiersin.org/articles/10.3389/fchem.2021.756716/full study] published in 2021 found "that the mean number of chemicals detected per product has in fact changed over the years; products collected in 2017 and 2018 appear to have a significantly higher number of chemical compounds when compared to those collected in 2019. This trend is observed regardless of flavour category analyzed. Of the 825 samples tested "diacetyl was detected in two vaping liquids acquired prior to 2018, 2,3 pentanedione was not detected in any vaping liquids analyzed in the Open Characterization dataset." No Diacetyl was found in the liquids acquired after 2018.


=Where can I get reliable information on vaping and Popcorn Lung?=
=Where can I get reliable information on vaping and Popcorn Lung?=
*February 20, 2018 - UK Health Security Agency - [https://ukhsa.blog.gov.uk/2018/02/20/clearing-up-some-myths-around-e-cigarettes/ Clearing up some myths around e-cigarettes]
*December 14, 2021 - Cancer Research UK - [https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/does-vaping-cause-popcorn-lung Does vaping cause popcorn lung?]
*June 14, 2023 - London Tobacco Alliance - [https://twitter.com/LTA_London/status/1668922749601947648 Vaping does not cause popcorn lung]
*September 12, 2023 - Government of Canada - [https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping/risks.html Risks of vaping]
*October 2, 2023 - Better Health NHS UK - [https://www.nhs.uk/better-health/quit-smoking/vaping-to-quit-smoking/vaping-myths-and-the-facts/ Vaping myths and the facts]
*November 16, 2023 - NCSCT UK (National Centre for Smoking Cessation and Training) - [https://www.ncsct.co.uk/publications/Vaping_briefing Vaping: a guide for health and social care professionals] (Click link on website to open the PDF of the guide)


=Are there any articles or Op-Eds trying to dispel this myth?=
=Are there any articles, videos, or Op-Eds pointing out the misinformation surrounding this myth?=
*December 8, 2015 - Dr Farsalinos - [https://www.ecigarette-research.org/research/index.php/whats-new/whatsnew-2015/236-da2 A new study finds diacetyl in e-cigarettes but exaggerates risks and fails to discuss about smoking]
*December 9, 2015 - Daily Caller - [https://dailycaller.com/2015/12/09/how-the-media-totally-exaggerated-study-on-risk-of-popcorn-lung-from-e-cigarettes/ How The Media Totally Exaggerated Study On Risk Of ‘Popcorn Lung’ From E-Cigarettes]
*December 10, 2015 - Dr. Michael Siegel - [https://tobaccoanalysis.blogspot.com/2015/12/new-study-finds-that-average-diacetyl.html New Study Finds that Average Diacetyl Exposure from Vaping is 750 Times Lower than from Smoking]
*December 10, 2015 - Dr Rodu - [https://rodutobaccotruth.blogspot.com/2015/12/is-harvard-e-cigarette-buttery-flavor.html Is the Harvard E-Cigarette Buttery Flavor Study Credible?]
*June 2016 - Carrie Arnold - [https://pmc.ncbi.nlm.nih.gov/articles/PMC4892907/ On the Vapor Trail: Examining the Chemical Content of E-Cigarette Flavorings]
*August 8, 2016 - Snopes.com - [https://www.snopes.com/fact-check/vaping-causes-popcorn-lung/ Vaping Causes 'Popcorn Lung'?]
*May 30, 2017 - Fact Check - [https://www.factcheck.org/2017/05/facts-e-cigarettes/ The Facts on E-Cigarettes]
*June 17, 2017 - The Florida Times-Union - [https://www.jacksonville.com/story/news/reason/2017/06/17/fact-check-do-e-cigarettes-cause-incurable-disease/15362803007/ Fact Check: Do e-cigarettes cause incurable disease]
*September 25, 2018 - Filter - [https://filtermag.org/the-war-on-nicotine/ The War on Nicotine Pits Prejudice Against Public Health]
*April 20, 2019 - Town Hall - [https://townhall.com/columnists/lindseystroud/2019/04/20/popcorn-lung-formaldehyde-and-now-seizures-oh-my-n2545040 Popcorn Lung, Formaldehyde, and Now Seizures, Oh My!]
*July 16, 2019 - Competitive Enterprise Institute - [https://cei.org/blog/bogus-e-cigarette-panic-literally-killing-people/ Bogus E-cigarette Panic Literally Killing People]
*October 17, 2019 - The Washington Post - [https://www.washingtonpost.com/outlook/five-myths/five-myths-about-vaping/2019/10/17/d3cc565e-f029-11e9-8693-f487e46784aa_story.html Five myths about vaping]
*October 17, 2019 - The Washington Post - [https://www.washingtonpost.com/outlook/five-myths/five-myths-about-vaping/2019/10/17/d3cc565e-f029-11e9-8693-f487e46784aa_story.html Five myths about vaping]
*December 3, 2019 - Filter - [https://filtermag.org/marijuana-nicotine-vaping/ Marijuana and Nicotine Are Trading Places as Prohibitionists’ Target]
*January 29, 2020 - Filter - [https://filtermag.org/vaping-minimum-21/ The New Federal Minimum Vaping Age Won’t Protect Young People]
*April 30, 2020 - Filter - [https://filtermag.org/anti-vaping-zealots-find-opportunity-in-the-pandemic/ Anti-Vaping Zealots Find Opportunity in the Pandemic]
*October 14, 2020 - Filter - [https://filtermag.org/covid-vaping/ COVID and Vaping: A Perfect Storm of Misleading Science and Media]
*July 2, 2021 - Taxpayers Protection Alliance - [https://www.youtube.com/watch?v=jhOhvhAJDSg The Truth About Popcorn Lung]
*July 28, 2021 - Filter - [https://filtermag.org/syringe-program-tobacco-harm-reduction/ How Can a Syringe Program Reject Harm Reduction for Smoking?]
*January 18, 2023 - The Center Square - [https://docs.google.com/document/d/10i5i8n-mihQ7Bru3QlVWxoMHPLeivsF2NEZQ9goQeBo/edit?usp=sharing The Collusion of Popcorn and Fear]
*February 13, 2023 - CASAA - [https://www.youtube.com/watch?v=swFQPFVg1u0 Debunking Vaping Myths | CASAA Explains]
*July 31, 2023 - Filter - [https://filtermag.org/lung-cancer-vaping-misinformation/ Stigma and Misinformation Maintain the Devastating Toll of Lung Cancer ]
*August 8, 2023 - The Studies Show - [https://www.thestudiesshowpod.com/p/episode-5-vaping#details Episode 5: Vaping, smoking, and popcorn lung]
*September 1, 2023 - Planet of the Vapes - [https://www.planetofthevapes.co.uk/news/vaping-news/2023-09-01_dr-kayat-back-with-more-nonsense.html Dr Kayat: Back With More Nonsense]
*September 11, 2023 - Reason Foundation - [https://reason.org/backgrounder/debunking-the-myth-that-vaping-causes-popcorn-lung/ Debunking the myth that vaping causes popcorn lung]
*September 12, 2023 - The Counterfactual - [https://clivebates.com/is-tobacco-control-the-new-big-tobacco/ Is tobacco control the new Big Tobacco?]
*September 22, 2023 - Filter - [https://filtermag.org/vaping-chemicals/ Dose Makes the Poison: The “Chemicals” Smear Against Vaping]
*October 2, 2023 - Filter - [https://filtermag.org/american-lung-association-harm-reduction/ American Lung Association Seeks to Suppress Harm Reduction Information]
*November 28, 2023 - Filter - [https://filtermag.org/vaping-guide-health-social-professionals/ A Valuable Vaping Guide for Health and Social Service Providers]
*December 6, 2023 - Dr. Colin Mendelsohn - Vaping FAQs - [https://colinmendelsohn.com.au/vaping/#does-vaping-cause-popcorn-lung Does vaping cause popcorn lung?]
*January 19, 2024 - Filter - [https://filtermag.org/harvard-health-vaping-popcorn-lung/ Harvard Health Stands by Misleading Article on Vaping and “Popcorn Lung”]
*December 26, 2024 - The Rest of the Story: Tobacco and Alcohol News Analysis and Commentary - [https://tobaccoanalysis.blogspot.com/2024/12/perhaps-most-misleading-and-damaging.html Top Ten Ridiculous E-Cigarettes Cause Popcorn Lung Claims of 2024]
*Year? - Canberra Alliance for Harm Minimisation and Advocacy (CAHMA) - [https://www.cahma.org.au/article/safer-using-vaping/ Safer Using – Vaping]
*Year? - ASH - [https://www.jpaget.nhs.uk/media/673895/Vaping-Frequently-Asked-Questions-Answered-by-ASH.pdf Vaping FAQ]


=Who has corrected or deleted their incorrect information on Popcorn Lung?=
=Who has corrected or deleted their incorrect information on Popcorn Lung?=
'''2015'''
*October 20, 2015 - American College of Chest Physicians - [https://www.eurekalert.org/news-releases/897313 Case report finds acute hypersensitivity pneumonitis in patient using e-cigarettes]
**"[CORRECTION] An October 19, 2015 version of this press release stated in error a diagnosis of bronchiolitis obliterans. Researchers reported a diagnosis of inhalational injury, suspected acute hypersensitivity pneumonitis, related to e-cigarette use."
**See Also: 2015: [http://www.ecigarette-research.org/research/index.php/whats-new/whatsnew-2015/234-bo Medical journal MISPRESENTS a case of hypersensitivity pneumonitis as popcorn lung disease caused by e-cigarette]
'''2023'''
*In December 2023, Harvard Health tweeted about Popcorn Lung. After a Community Note was post to it, Harvard [https://twitter.com/GregTHR/status/1739802372983972248 deleted] the tweet.
<br>
[[File:Harvard Health Tweet.png|center]]
<br>
'''2024'''
*Sometime between December 7 and 18, 2024, Harvard T.H. Chan School of Public Health - Removed this Press Release from their website: Chemicals linked with severe respiratory disease found in common e-cigarette flavors. (Link saved on [https://web.archive.org/web/20151212202826/https://www.hsph.harvard.edu/news/press-releases/e-cigarette-flavoring-chemicals-linked-to-respiratory-disease/ Wayback Machine.])
'''2025'''
*In April 2025, Raidió Teilifís Éireann, Ireland's National Public Service Media, Tweeted (see screenshot) about popcorn lung and put the information on their [https://www.rte.ie/brainstorm/2025/0430/1510257-popcorn-lung-vaping-explained/ website]. On May 2, 2025, they deleted the tweet and removed the website page after receiving three community notes. ([https://web.archive.org/web/20250501085241/https://www.rte.ie/brainstorm/2025/0430/1510257-popcorn-lung-vaping-explained/ see archived link to website page])
<br>
[[File:RTE Popcorn Lung.png|center]]
<br>
*In May 2025, the Irish Thoracic Society deleted their tweet alluding to a connection between popcorn lung and vaping. (Deleted before a screenshot was captured.)
=Who's information can lead people to believe that vaping causes Popcorn Lung?=
Some of these websites don't specifically say that people who vape get Popcorn Lung. They mention diacetyl is in e-cigarettes and that diacetyl can cause popcorn lung. Their failure lies in neglecting to point out that popcorn lung is rare, there is more diacetyl in combustible cigarettes than vapor products, and there are no [https://tobaccoanalysis.blogspot.com/2018/05/e-cigarette-opponents-still-making-up.html documented] cases of popcorn lung that can be directly attributed to smoking or vaping that has been medically verified.
===Cites Harvard researcher's study or press release as source===
*Dec 8, 2015 - Harvard T.H. Chan School of Public Health - Press Release - "Chemicals linked with severe respiratory disease found in common e-cigarette flavors." (Link saved on [https://web.archive.org/web/20151212202826/https://www.hsph.harvard.edu/news/press-releases/e-cigarette-flavoring-chemicals-linked-to-respiratory-disease/ Wayback Machine])
*Dec 8, 2015 - Time - [https://time.com/4139335/e-cigarettes-chemicals-diacetyl/ The Butter Flavor Chemical Used in Microwave Popcorn Is Also in E-Cigs]
*Dec 8, 2015 - The Verge - [https://www.theverge.com/2015/12/8/9873458/e-cigarette-vape-lung-disease-diacetyl-cupcake-cotton-candy Some e-cigarette flavors contain chemical linked to 'popcorn lung' disease]
*Dec 9, 2015 - Vox - [https://www.vox.com/2015/12/9/9880926/e-cigarettes-popcorn-lung-harms Some e-cigarettes contain chemicals that cause "popcorn lung"]
*Dec 9, 2015 - Milwaukee Wisconsin Journal Sentinal - [https://web.archive.org/web/20151211035931/https://www.jsonline.com/watchdog/watchdogreports/harvard-study-confirms-dangers-of-vaping-b99631238z1-361343541.html/ Gasping For Action | Watchdog Update Harvard study confirms dangers of vaping]
*2015 & 2021 - World Health Organization
**[https://cdn.who.int/media/docs/default-source/regulating-tobacco-products/backgroundpapersends3-4november-.pdf 2015 A systematic review of health effects of electronic cigarettes]
**[https://pnsd.sanidad.gob.es/profesionales/publicaciones/catalogo/bibliotecaInternacionales/publicaciones/pdf/2021_WHO_Report_on_Global_Tobacco_Epidemic.pdf 2021 WHO REPORT ON THE GLOBAL TOBACCO EPIDEMIC]
*Oct 25, 2016 - ADCES in Practice, an official publication of the Association of Diabetes Care & Education Specialists - [https://journals.sagepub.com/doi/10.1177/2325160316666115 Electronic Nicotine Delivery Systems and a Suggested Approach to Vaping Cessation] - [https://sci-hub.se/10.1177/2325160316666115 (PDF Version of full paper)]
*2016 - American Lung Association (ALA) - [https://www.lung.org/blog/popcorn-lung-risk-ecigs Popcorn Lung: A Dangerous Risk of Flavored E-Cigarettes] - WayBack Machine Links: [https://web.archive.org/web/20160709232304/http://www.lung.org/about-us/blog/2016/07/popcorn-lung-risk-ecigs.html July 2016] and still online [https://web.archive.org/web/20240120181104/https://www.lung.org/blog/popcorn-lung-risk-ecigs January 2024]. (wording slightly changed)
**NOTE: See ALA citations below
*Apr 3, 2017 - Healing Oracle - [https://healingoracle.ch/2017/04/03/confirmed-e-cigarettes-cause-a-horrible-incurable-disease-called-popcorn-lung-worse-than-lung-cancer/ CONFIRMED: E-CIGARETTES CAUSE A HORRIBLE INCURABLE DISEASE CALLED ‘POPCORN LUNG’. WORSE THAN LUNG CANCER!]
*2019 - [https://documents1.worldbank.org/curated/en/356561555100066200/pdf/E-Cigarettes-Use-and-Taxation.pdf World Bank Group Global Tobacco Control Program]
*Nov 15, 2019 - Hawaii Public Health Institute - [https://www.hiphi.org/what-is-popcorn-lung-and-can-you-get-it-from-vaping/ What Is Popcorn Lung, and Can You Get It from Vaping?]
*November 7, 2022 - Charlie Health - [https://www.charliehealth.com/research/vaping-teen-health-what-you-need-to-know  Vaping & Teen Health: What You Need to Know]
*Dec 21, 2023 - Harvard Health Publishing - Popcorn lung: What is it, and who is at risk? (which was changed - more [https://www.health.harvard.edu/diseases-and-conditions/popcorn-lung-what-is-it-and-who-is-at-risk misleading]!) [https://web.archive.org/web/20240116112026/https://www.health.harvard.edu/diseases-and-conditions/popcorn-lung-what-is-it-and-who-is-at-risk Jan 2, 2024] - See old version [https://web.archive.org/web/20231228054251/https://www.health.harvard.edu/diseases-and-conditions/popcorn-lung-what-is-it-and-who-is-at-risk Dec 21, 2023])
*Jan 23, 2024 - Recovered - [https://recovered.org/blog/the-risks-of-vaping The Risks of Vaping]
*February 23, 2024 - Hindustan Times - [https://www.hindustantimes.com/lifestyle/health/what-is-popcorn-lung-a-rare-condition-caused-by-vaping-know-signs-and-symptoms-101708668571913.html What is popcorn lung, a rare condition caused by vaping? Know signs and symptoms]. [https://twitter.com/htlifeandstyle/status/1760913850155573668 Tweet]
*Mar 2, 2024 - Health Shots - [https://www.healthshots.com/preventive-care/self-care/popcorn-lung/ Beware of popcorn lung, a rare condition that can’t be cured!]
*Aug 1, 2024 - [https://www.medicinenet.com/popcorn_lung_bronchiolitis_obliterans/article.htm Popcorn Lung (Bronchiolitis Obliterans)]
*Date??? - Colusa County, California - [https://www.countyofcolusaca.gov/773/Reducing-the-Influence-of-Tobacco-Market Reducing the Influence of Tobacco Marketing]
===Cites [https://www.lung.org/blog/popcorn-lung-risk-ecigs American Lung Association] as source===
*ACMH Armstrong County Memorial Hospital - [https://www.acmh.org/vape Vaping is not the 'safer' alternative for your kids...] - Post on [https://www.facebook.com/100057125002274/posts/3221582947882476/?rdid=Mpk4N2jYgyd7NTAR Facebook] September 18, 2019.
*ALA's [https://www.tiktok.com/@americanlungassociation/video/7066575989953989935 TikTok] video.
*Alternative to Meds Center - [https://www.alternativetomeds.com/blog/warning-before-you-vape-again-read-these-harmful-effects-of-vaping/ Warning: Before You Vape Again, Read These Harmful Effects of Vaping] - Feb 2, 2024
*American Journal of Managed Care® (AJMC®) - [https://www.ajmc.com/view/vaping-risks-known-and-unknown Vaping Risks: Known and Unknown] - November 5, 2024
*DUKE UNC Tobacco Treatment Specialist Training Program - [https://www.dukeunctts.com/post/3-facts-about-e-cigarettes-everyone-should-know 3 Facts About E-Cigarettes Everyone Should Know] - November 4, 2024
*Health - [https://www.health.com/popcorn-lung-symptoms-8426051 Signs and Symptoms of Popcorn Lung] - Jan 24, 2024 [https://twitter.com/health_com_/status/1751659678658937163 Tweet]
*INTEGRIS Health - [https://integrishealth.org/resources/on-your-health/2024/november/does-vaping-cause-lung-cancer Does Vaping Cause Lung Cancer?] - November 1, 2024
*PATHS Program - [https://pathsprogram.com/blog/2024/3/19/the-dangers-of-vaping The Dangers of Vaping] - March 19, 2024
*PharmEasy - [https://web.archive.org/web/20230703192358/https://pharmeasy.in/blog/does-vaping-cause-cancer-exploring-the-health-implications/ Does Vaping Cause Cancer? Exploring The Health Implications] - Feb 14, 2024
*The Conversation - [https://theconversation.com/popcorn-lung-how-vaping-can-scar-your-lungs-for-life-254414 Popcorn lung: how vaping can scar your lungs for life] - April 25, 2025
*University of Northern Colorado - [https://www.unco.edu/student-health-center/health-topics/vaping.aspx Vaping and E-Cigarettes] - Jun 11, 2022
*University of North Texas - [https://www.unthsc.edu/school-of-public-health/vaping-advice-for-parents/ Vaping advice for parents] - Sep 19, 2019
*Very Well Health - [https://www.verywellhealth.com/does-vaping-cause-lung-cancer-5208733 Does Vaping Cause Lung Cancer?] - Sep 29, 2024.
*Very Well Health - [https://www.verywellhealth.com/can-vaping-cause-cancer-8693704 Can Vaping Cause Cancer? What Does It Do to Your Lungs?] - August 22, 2024
*WVNS 59 News - [https://www.wvnstv.com/community/health/popcorn-lung-and-the-dangers-associated-with-it/ ‘Popcorn Lung’ and what to look out for] - Feb 5, 2024 - [https://twitter.com/WVNS59News/status/1754823014309343660 Tweet]
===Cites Johns Hopkins as the source (Johns Hopkins doesn't cite their source)===
*Johns Hopkins Medicine - [https://web.archive.org/web/20200805224246/https://www.hopkinsmedicine.org/health/wellness-and-prevention/what-does-vaping-do-to-your-lungs What Does Vaping Do to Your Lungs?] - Aug 5, 2020 (Date is the earliest saved date on WayBack Machine)
*Charlie Health - [https://www.charliehealth.com/research/vaping-teen-health-what-you-need-to-know  Vaping & Teen Health: What You Need to Know] - November 7, 2022
*Patch - [https://patch.com/new-york/glencove/safe-gc-coalition-popcorn-lung-not-be-taken-lightly SAFE GC Coalition: Popcorn Lung Not to Be Taken Lightly] - March 14, 2023
*Times of India - [https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/what-is-popcorn-lung-signs-and-symptoms-you-should-be-aware-of/photostory/107829266.cms?picid=107829277 What is Popcorn Lung? Signs and symptoms you should be aware of] - Feb 20, 2024
*USA Today - [https://www.usatoday.com/story/life/health-wellness/2024/07/17/vaping-smoking-side-effects/74087476007/ Is vaping better than smoking? Here's what experts say.] - July 17, 2024
*Van Law Firm - [https://vanlawfirm.com/faqs/e-cigarettes-vaping-linked-to-lung-injury/ E-Cigarettes & Vaping Linked to Lung Injury] - Date Unknown
===Cites sources other than Harvard or American Lung Association===
*American Heart Association - [https://www.ahajournals.org/doi/10.1161/CIR.0000000000001160 Cardiopulmonary Impact of Electronic Cigarettes and Vaping Products]: A Scientific Statement From the American Heart Association - Jul 17, 2023
**See Also: May 31, 2022 - American Heart Association - [https://www.heart.org/en/news/2022/05/31/in-secondhand-vape-scientists-smell-risk In secondhand vape, scientists smell risk]
*International Journal of Advance Research in Medical Surgical Nursing [https://www.surgicalnursingjournal.com/archives/2021.v3.i1.A.61 Dangerous popcorn lung: A risk of flavored e-cigarettes] - 2021
*Iris Journal of Nursing & Care - [https://irispublishers.com/ijnc/fulltext/the-roles-of-the-nurse-during-the-vaping-crisis.ID.000537.php The Roles of the Nurse During the Vaping Crisis] - Dec 17, 2019
*Mirror - [https://www.mirror.co.uk/news/health/nhs-lung-specialist-warns-severe-33862603 NHS lung specialist warns of severe risks from vaping – including 'intensive care'] - Oct 10, 2024 - (Source: Someone claiming to be a Dr. on a TikTok video)
*The Journal of Physiology  - [https://physoc.onlinelibrary.wiley.com/doi/10.1113/JP279526 E-cigarettes and respiratory health: the latest evidence] - Jun 3, 2020 - (Source: EU Tobacco Products Directive 2016)
*The Conversation - [https://theconversation.com/vaping-now-more-common-than-smoking-among-young-people-and-the-risks-go-beyond-lung-and-brain-damage-223125 Vaping now more common than smoking among young people – and the risks go beyond lung and brain damage] - Apr 25, 2024
===No Citation of source===
*Alberta Lung Association - Re: Popcorn Lung - [https://x.com/AlbertaLung/status/1842603276249727419 The condition can still be caused by vaping today.] - Oct 4, 2024. That tweet received a Community Note.
*American Cancer Society - [https://www.cancer.org/cancer/risk-prevention/tobacco/e-cigarettes-vaping.html E-cigarettes and Vaping] - Last Revised: November 19, 2024
*American Heart Association – Eastern States, This article was provided by Bayhealth - [https://easternstates.heart.org/2024/02/21/the-dangers-of-vaping/ The Dangers of Vaping] - February 21, 2024
*Apollo Hospitals - [https://x.com/HospitalsApollo/status/1913226138991710502 Did you know vaping and e-cigarettes can lead to a condition called Popcorn Lung?]- Apr 18,2025
*Beaufort Memorial Hospital - [https://www.bmhsc.org/blog/can-vaping-cause-lung-cancer-what-we-know-so-far Can Vaping Cause Lung Cancer? What We Know So Far] - November 14, 2024
*Business Universe - [https://www.businessuniverse.in/the-mystery-of-popcorn-lung-signs-symptoms-and-the-vaping-connection The Mystery of Popcorn Lung: Signs, Symptoms, and the Vaping Connection] - [https://www.businessuniverse.in/health Feb 20, 2024] (points out potential, does not say it causes it)
*CDC - [https://web.archive.org/web/20170420150557/https://e-cigarettes.surgeongeneral.gov/documents/SGR_E-Cig_Health_Care_Provider_Card_508.pdf Health Care Professionals: Educate Your Young Patients About the Risks of E-cigarettes] -Apr 20, 2017 (Date is the earliest date on WayBack Machine)
*Cinncinati Enquirer - [https://www.cincinnati.com/story/opinion/editorials/2024/01/31/ban-flavored-tobacco-end-vape-crisis-cincinnati/72152616007/ Cincinnati must pick up the pace on banning flavored tobacco] - Jan 31, 2024
*Cleveland Clinic - [https://web.archive.org/web/20220807182718/https://my.clevelandclinic.org/health/diseases/22590-popcorn-lung-bronchiolitis-obliterans Popcorn Lung (Bronchiolitis Obliterans)] - Apr 7, 2022 (Date is the earliest date on WayBack Machine) (Misleading information about vaping is still on their website [https://my.clevelandclinic.org/health/diseases/22590-popcorn-lung-bronchiolitis-obliterans Oct 7, 2024]). Popcorn Lung is also mentioned on their [https://my.clevelandclinic.org/health/treatments/21162-vaping Vaping (E-Cigarettes)] page.
*Covenant Health - [https://www.covenanthealth.com/blog/effects-of-vaping-on-teens/ The Effects of Vaping on Teens and Young Adults]
*Daily Mail - [https://www.dailymail.co.uk/health/article-13057345/vaping-dangerous-cigarettes-report-dangers-lung-disease.html How dangerous IS vaping compared with smoking? New review analyzes the dangers of both.... and finds former is linked to EIGHT lung diseases] - Feb 8, 2024
*Daily Mail - [https://www.dailymail.co.uk/health/article-11011221/Up-95-people-develop-severe-popcorn-lung-result-vaping-DIE.html Expert warns that up to 95% of people who develop severe 'popcorn lung' as a result of vaping will DIE within five years of developing the disease] - July 14, 2022
*Dr. Peace, forensic toxicologist - [https://www.news-medical.net/news/20240723/E-Cigarettes-and-Ethanol-A-forensic-Perspective-on-Vaping.aspx E-Cigarettes and Ethanol: A Forensic Perspective on Vaping] - July 23, 2024
*Dr Zac Turner, medical practitioner specialising in preventative health and wellness - [https://www.news.com.au/lifestyle/health/health-problems/popcorn-lung-doctor-reveals-shock-truth-about-vaping/news-story/636eceb0f1808de9ca034b38bc417c62 ‘Popcorn lung’: Doctor reveals shock truth about vaping] - Aug 25, 2024
*Essentia Health - [https://www.essentiahealth.org/about/essentia-health-newsroom/cancer-can-vaping-cause-lung-cancer-or-other-diseases Can Vaping Cause Lung Cancer or Other Diseases?] - October 28, 2024
*Grand Forks, ND, Department of Public Health - [https://x.com/GFPublicHealth/status/1901345281347821853 Do you know about vaping and popcorn lung?] - Mar 16, 2025
*Houston Methodist - [https://www.houstonmethodist.org/blog/articles/2024/dec/does-vaping-cause-lung-cancer/ Does Vaping Cause Lung Cancer?] - December 9, 2024
*James A Vito, D.M.D. - [https://www.jamesvito.com/blog/2024/1/23/is-vaping-safe-part-2/ Is Vaping Safe: Part 2] - January 23, 2024
*KYW Newsradio Audio On-Demand - [https://www.audacy.com/podcast/kyw-newsradio-audio-on-demand-12880/episodes/cases-of-popcorn-lung-are-growing-among-young-people-who-vape-37155?_branch_match_id=1015711130154785438&_branch_referrer=H4sIAAAAAAAAA8soKSkottLXT8%2FXSyxNSUyu1EvOz9U3D4wMLwwxqYo Cases of ‘popcorn lung’ are growing among young people who vape] - April 30, 2025
*Manor Dental Health - [https://www.manordentalhull.com/why-vaping-is-just-as-harmful-as-smoking/ Why Vaping is Just as Harmful as Smoking] - September 18, 2024
*Med India - [https://www.medindia.net/news/healthwatch/vapers-beware-exploring-the-threat-of-popcorn-lung-215028-1.htm Vapers Beware: Exploring the Threat of Popcorn Lung] - February 20, 2024
*Montgomery Community Media - [https://www.mymcmedia.org/medical-professional-links-popcorn-lung-disease-to-vaping/ Medical Professional Links ‘Popcorn Lung’ Disease to Vaping] - September 4, 2019
*Metro - [https://metro.co.uk/2025/01/16/dangerous-impact-vaping-can-lungs-22375303/ The dangerous impact vaping can have on your lungs] - Jan 16, 2025
*NMC Health - [https://www.mynmchealth.org/5-things-to-know-about-vaping/ 5 things to know about vaping] - March 11, 2021
*Parkview Health - [https://www.parkview.com/blog/e-cigarettes-know-the-risks E-cigarettes: Know the risks] - Nov 9, 2023 (article mentions "diacetyl, a chemical linked to a serious lung disease).
*Patch (West Haven, CT) - [https://patch.com/connecticut/westhaven/whats-your-vape What's In Your Vape?] - January 6, 2025
*Public Health Delta Menominee - [https://www.instagram.com/ph_deltamenominee/p/DB_ntOMCKTK/ Vaping can cause popcorn lung] - November 5, 2024
*Regional Cancer Care Associates - [https://www.regionalcancercare.org/news/does-vaping-cause-lung-cancer/ Does Vaping Cause Lung Cancer?] - February 21, 2024
*Sacramento County, California - [https://x.com/SacCountyCA/status/1902797294858023000 Vaping can lead to lung disease, “Popcorn Lung,” and even a collapsed lung.] - Mar 20, 2025
*St. Michael’s Elite Hospital - [https://24hrer.com/the-great-american-smokeout-focus-on-vaping/ The Great American Smokeout – Focus on Vaping] - Date Unknown
*Tempe Coalition - [https://www.tempecoalition.org/initiatives/tobacco-cessation/ Addressing the Youth Vaping Crisis] - Date Unknown
*The Citizen - [https://www.citizen.co.za/lifestyle/health/vaping-popcorn-lung-predicament/ Vaping’s popcorn lung predicament] - June 27, 2024
*The Conversation - [https://theconversation.com/vaping-now-more-common-than-smoking-among-young-people-and-the-risks-go-beyond-lung-and-brain-damage-223125 Vaping now more common than smoking among young people – and the risks go beyond lung and brain damage] - April 25, 2024
*The Postline (video) - [https://www.youtube.com/watch?v=dmVFr--YHCg&t=36s Popcorn lung disease: What is it, and how does it link to vaping?] - Feb 24, 2024
*Tobacco Stops With Me - [https://stopswithme.com/dangers-of-tobacco-products/vaping-e-cigarettes/ The Dangers of Vaping] (date unknown)
*ToucanEd - [https://www.youtube.com/watch?v=KKGSaWnj4fU It's a Fact. Vaping Can Cause Popcorn Lung Poster] - October 1, 2024
*University Hospitals - [https://www.uhhospitals.org/blog/articles/2024/04/popcorn-lung-a-dangerous-risk-of-vaping Popcorn Lung: A Dangerous Risk of Vaping] - Apr 25, 2024
*University of Michigan Health - [https://www.mymichigan.org/about/news/healthdoseblog/vaping-safe-or-not/ Vaping: Safe? Or Are Your Lungs Going Up In Smoke?] - June 4, 2024
*University of Rochester Medical Center - [https://www.urmc.rochester.edu/news/publications/health-matters/talking-to-your-teen-who-vapes Talking to Your Teen Who Vapes] - April 20, 2024
*University of Texas MD Anderson Cancer Center - [https://www.mdanderson.org/cancerwise/does-vaping-cause-lung-cancer.h00-159694389.html Does vaping cause lung cancer?] - Jan 5, 2024
*University of Virginia - [https://blog.uvahealth.com/2019/08/23/popcorn-lung/ The Lessons of Popcorn Lung: Inhale With Caution] - Aug 23, 2019 (Source is quotes from two doctors)
*Utah State University - [https://www.usu.edu/today/story/ask-an-expert--youth-vaping-what-you-need-to-know Ask an Expert — Youth Vaping: What You Need to Know] - October 14, 2024
*WA Country Health Services - [https://www.youtube.com/watch?v=Odlq6UdoLJE E-cigarettes can cause popcorn lung (7 seconds advert)] - March 23, 2021
*WebMD [https://web.archive.org/web/20180731112828/https://www.webmd.com/lung/popcorn-lung#1 2018] and still online [https://web.archive.org/web/20240121091642/https://www.webmd.com/lung/popcorn-lung January 2024]
*WebMD - [https://www.webmd.com/lung/copd/vaping-copd-related COPD and Vaping] - March 1, 2024
*You Curious? (video) - [https://www.youtube.com/watch?v=wzPE6TAp10o The Vaping Industry's Deadly Secret | Why Vaping is More Dangerous Than We Thought] - January 4, 2025
('''To Do List - SAVE all links on Wayback''')
=Studies Comparing Diacetyl in Combustible Cigarettes and Vapor Products=


=Who is sharing incorrect information on Popcorn Lung?=
===2014 - [https://pmc.ncbi.nlm.nih.gov/articles/PMC4892705/ Evaluation of Electronic Cigarette Liquids and Aerosol for the Presence of Selected Inhalation Toxins]===
*American Lung Association - originally online [https://web.archive.org/web/20160709232304/http://www.lung.org/about-us/blog/2016/07/popcorn-lung-risk-ecigs.html July 2016] and still online [https://web.archive.org/web/20240120181104/https://www.lung.org/blog/popcorn-lung-risk-ecigs January 2024].  
*"As mentioned previously, the median daily levels of DA and AP exposure from EC use were estimated to be 56 μg and 91 μg respectively, which are 100 and 10 times lower compared to smoking (Mann-Whitney p < .001 for DA and p = .020 for AP)."
 
=Addendum=
We are not health care practitioners. The information here is not meant to be medical advice. Due to overwhelming amounts of [https://safernicotine.wiki/mediawiki/index.php?title=Nicotine_-_Misperceptions,_Misinformation,_or_Disinformation misinformation] about nicotine, it is difficult to get accurate medical advice. The best thing you can do is not vape or smoke. Clean (unpolluted) air is the best thing for your lungs. If you wish to inhale nicotine, current evidence shows that while not "safe," vaping is [https://safernicotine.wiki/mediawiki/index.php?title=Myth:_Alternative_nicotine_products_are_as_dangerous_as_smoking safer] than smoking and can help some people [https://safernicotine.wiki/mediawiki/index.php?title=Myth:_Alternative_nicotine_products_don%27t_help_people_stop_smoking stop] smoking.


=Suggestions to add to this page=
=Suggestions to add to this page=
===2025: [https://rodutobaccotruth.blogspot.com/2025/07/follow-up-to-my-expose-on-american-lung.html Follow-Up to My Exposé on the American Lung Association]===
*Follow up to: [https://rodutobaccotruth.blogspot.com/2025/07/wave-goodbye-with-your-wallet-to.html Wave Goodbye With Your Wallet to the American Lung Association]

Latest revision as of 19:02, 29 July 2025



What is Popcorn Lung?

The technical term for this illness is Bronchiolitis obliterans. It can be referred to as obliterative bronchiolitis or bronchiolitis obliterans syndrome. It has also been called “Silo-fillers Lung” due to people becoming ill after breathing the gasses from sillage.

Bronchiolitis obliterans is a rare lung condition that affects the small airways, blocking air movement by causing constriction and scarring.

Most patients with Bronchiolitis obliterans are treated with medications and therapy by a multidisciplinary team.Those patients will experience a poor quality of life, and the majority of them will die prematurely from respiratory failure.

What causes Popcorn Lung / Bronchiolitis Obliterans?

Bronchiolitis obliterans is rare. It was first mentioned in 1835, and it was not until 1901 that it was mentioned again in medical writings. At that time, inhalation of toxic fumes or foreign bodies and respiratory infections were attributed to causing Bronchiolitis obliterans.

Bronchiolitis obliterans syndrome afflicts about 50% of lung transplant patients within five years and 2% - 6% of hematopoietic stem cell transplantation patients. Some patients with autoimmune diseases are prone to it, too.

Bronchiolitis obliterans can occur after chemical agent exposure, which has been an occupational hazard in agriculture and manufacturing. It has affected workers who make microwave popcorn,coffee,flavorings, etc. It has been found in employees of textile and other industries. Veterans exposed to gasses and burn pits,along with people exposed to the dust and fumes from the collapse of the World Trade Center, have also experienced bronchiolitis obliterans. Some viral infections can cause bronchiolitis obliterans.

If it has a scientific name, why is it called Popcorn Lung?

From the Centers for Disease Control and Prevention: "In 2000, a physician reported that eight former microwave-popcorn factory workers had developed a rare and disabling lung disease, bronchiolitis obliterans. Four of the eight workers were ill and put on lung transplant waiting lists. After investigating numerous possible sources, researchers ultimately determined the cause of lung damage: a vapor from butter flavoring added to the popcorn."

Diacetyl is the chemical that gave the microwave popcorn its buttery flavor.

How is bronchiolitis obliterans (Popcorn Lung) diagnosed?

"If you have some of the symptoms of bronchiolitis obliterans, your doctor might recommend a computerized tomography (CT) scan of your chest. Several X-rays are taken from different angles and are put together to make a more complete picture. They'll probably also want to test how well your lungs are working.

A chest X-ray might tell your doctor if your lungs are holding in too much air, but the best way to confirm you have bronchiolitis obliterans is to have a biopsy. This is most often done with surgery." (Source WebMD) (Emphasis added)

Is Popcorn Lung the same thing as EVALI?

The two diseases are often conflated but are not the same.

While a variety of things can cause bronchiolitis obliterans (Popcorn Lung), it has been determined that E-cigarette, or Vaping, product use-Associated Lung Injury (EVALI) can be attributed to the addition of Vitamin Eto make unregulated vape cartridges containing tetrahydrocannabinol (THC) from marijuana look thick and of higher quality. The additive was used for a brief period of time in 2019-2020. These thickeners were pulled from the market by their manufacturers as news of the EVALI outbreak spread.

Nicotine vapor products did not cause EVALI. Leading experts requested the Centers for Disease Control and Prevention (CDC) change the name of EVALI to help consumers better understand the difference between vaping THC and nicotine. The CDC declined to make that change.

Why are some experts claiming vaping causes Popcorn Lung?

In 2015 the paper "Flavoring Chemicals in E-Cigarettes: Diacetyl, 2,3-Pentanedione, and Acetoin in a Sample of 51 Products, Including Fruit-, Candy-, and Cocktail-Flavored E-Cigarettes"was published. The authors found Diacetyl in some of the e-liquids they tested. They concluded, "Our findings confirm the presence of diacetyl and other flavoring chemicals in flavored e-cigarettes. Because of the associations between diacetyl and bronchiolitis obliterans and other severe respiratory diseases among workers inhaling heated vapors containing diacetyl, urgent action is recommended to further evaluate the extent of this new exposure to diacetyl and related flavoring compounds in e-cigarettes." (The vapors that workers inhaled were not vapor from an e-cigarette.) Twitter thread about study.

Harvard T.H. Chan School of Public Health issued a press release about the study, "Chemicals linked with severe respiratory disease found in common e-cigarette flavors"(Link saved on Wayback Machine.)While the safety of e-cigarettes does need to be monitored, the study and the press release did not compare the levels of the chemicals found to what is inhaled from smoking a combustible cigarette. Neither the paper nor the press release said people will get Popcorn Lung from vaping. They just raised concern about the possibility.

While Dr. Farsalinos is strongly opposed to the use of Diacetyl in e-liquids, he is concernedabout the study because "the article is creating false impressions and exaggerates the potential risk from diacetyl and acetyl propionyl exposure through e-cigarettes. They failed to mention that these chemicals are present in tobacco cigarette smoke and violated a classical toxicological principle that the amount determines the toxicity and the risk."

Dr. Brad Rodu has concerns about the methods used in this study and said in his blog,"As I advised previously, vapers should only use liquids that are certified to be free of buttery flavors that are suspected respiratory toxicants. However, laboratory investigations of e-cigarettes should use validated methods to assure credibility. The results of the Harvard Buttery Flavor Study do not meet this standard."

Science writer Carrie Arnold commentedon this study and said, "This study did not assess levels of diacetyl, 2,3-pentanedione, and acetoin in actual users, much less health effects. So it’s premature to assume that exposure to these chemicals via e-cigarettes causes health problems."

The study and alarmover the potentialdanger of vaping made headlinesacross the US and globally.Most of the articles failed to mention there are moreof these chemicals in combustible cigarettes,and there are no documentedcases of Popcorn Lung being caused by smokingor vaping.

A chemical of concern that might pose potential harm swiftly morphed into known harm, and word began to spreadthat vaping causes Popcorn Lung, even though there were no documented cases of it actually occurring. A 2015 report published in the Milwaukee Journal Sentinalgave a historical run-down of cases of Popcorn Lung in the food industry and questioned why Diacetyl was allowed in e-cigarettes.

The American Lung Association added informationabout Popcorn Lung and vaping on their website in 2016, leading the public to believe that vaping causes Popcorn lung when there have been no biopsy confirmed cases that can be confirmed to be caused by vaping.

In 2018, Jonathan Winickoff,the former chair of the American Academy of Pediatrics Tobacco Consortium, a pediatrician at Massachusetts General Hospital and a professor at Harvard Medical School, said that he "believes that the vape industry is co-opting the national wellness trend—when, in fact, vaping can cause something called bronchiolitis obliterans, or popcorn lung."

Schools, in an attemptto keep teens safe and discourage them from experimenting with vaping began telling studentsthey could get Popcorn Lung from vaping.

Misperceptions about the risk of getting Popcorn Lung from vaping can lead some people who smoke to avoidtrying this safer alternative to help them quit smoking. A point that was made by Jennifer Pierce, Anders Abelmann, and Brent Finley in their commentaryabout the 2015 flavoring study.

What actions were taken to protect consumers after the study was released?

  • Many e-liquid manufacturers switched to Diacetyl-free ingredients.
  • Most flavor manufacturers reformulated their flavoring to Diacetyl-free formulas.
  • As a further precaution to avoid the potential for there to be an issue in the future, some countries have banned the use of Daicetyl in e-liquids. Examples include Australia,Northern Ireland, Great Britain, and member states of the EU Tobacco Products Directive (TPD).
  • A study published in 2021 found "that the mean number of chemicals detected per product has in fact changed over the years; products collected in 2017 and 2018 appear to have a significantly higher number of chemical compounds when compared to those collected in 2019. This trend is observed regardless of flavour category analyzed. Of the 825 samples tested "diacetyl was detected in two vaping liquids acquired prior to 2018, 2,3 pentanedione was not detected in any vaping liquids analyzed in the Open Characterization dataset." No Diacetyl was found in the liquids acquired after 2018.

Where can I get reliable information on vaping and Popcorn Lung?

Are there any articles, videos, or Op-Eds pointing out the misinformation surrounding this myth?

Who has corrected or deleted their incorrect information on Popcorn Lung?

2015

2023

  • In December 2023, Harvard Health tweeted about Popcorn Lung. After a Community Note was post to it, Harvard deleted the tweet.



2024

  • Sometime between December 7 and 18, 2024, Harvard T.H. Chan School of Public Health - Removed this Press Release from their website: Chemicals linked with severe respiratory disease found in common e-cigarette flavors. (Link saved on Wayback Machine.)

2025

  • In April 2025, Raidió Teilifís Éireann, Ireland's National Public Service Media, Tweeted (see screenshot) about popcorn lung and put the information on their website. On May 2, 2025, they deleted the tweet and removed the website page after receiving three community notes. (see archived link to website page)



  • In May 2025, the Irish Thoracic Society deleted their tweet alluding to a connection between popcorn lung and vaping. (Deleted before a screenshot was captured.)

Who's information can lead people to believe that vaping causes Popcorn Lung?

Some of these websites don't specifically say that people who vape get Popcorn Lung. They mention diacetyl is in e-cigarettes and that diacetyl can cause popcorn lung. Their failure lies in neglecting to point out that popcorn lung is rare, there is more diacetyl in combustible cigarettes than vapor products, and there are no documented cases of popcorn lung that can be directly attributed to smoking or vaping that has been medically verified.

Cites Harvard researcher's study or press release as source

Cites American Lung Association as source

Cites Johns Hopkins as the source (Johns Hopkins doesn't cite their source)

Cites sources other than Harvard or American Lung Association

No Citation of source

(To Do List - SAVE all links on Wayback)

Studies Comparing Diacetyl in Combustible Cigarettes and Vapor Products

2014 - Evaluation of Electronic Cigarette Liquids and Aerosol for the Presence of Selected Inhalation Toxins

  • "As mentioned previously, the median daily levels of DA and AP exposure from EC use were estimated to be 56 μg and 91 μg respectively, which are 100 and 10 times lower compared to smoking (Mann-Whitney p < .001 for DA and p = .020 for AP)."

Addendum

We are not health care practitioners. The information here is not meant to be medical advice. Due to overwhelming amounts of misinformation about nicotine, it is difficult to get accurate medical advice. The best thing you can do is not vape or smoke. Clean (unpolluted) air is the best thing for your lungs. If you wish to inhale nicotine, current evidence shows that while not "safe," vaping is safer than smoking and can help some people stop smoking.

Suggestions to add to this page

2025: Follow-Up to My Exposé on the American Lung Association

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