Myth: Vaping causes Popcorn Lung: Difference between revisions

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].  

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 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.  

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.

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.