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=="EVALI"== <!--T:2--> | =="EVALI"== <!--T:2--> | ||
===2022: [https://onlinelibrary.wiley.com/doi/10.1111/add.16097 United States public health officials need to correct e-cigarette health misinformation]=== | |||
===[https://drive.google.com/file/d/1XMJ_JiqyiEa-bpcG4Ev7XyCROSt9k8RM/view Request by 75 experts to CDC to rename EVALI]=== <!--T:3--> | ===2022: [https://filtermag.org/vape-misinformation-surgeon-general/ End Vape Misinformation, Tobacco Control Experts Urge Surgeon General]=== | ||
===2021: [https://drive.google.com/file/d/1XMJ_JiqyiEa-bpcG4Ev7XyCROSt9k8RM/view Request by 75 experts to CDC to rename EVALI]=== <!--T:3--> | |||
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This letter is signed by seventy-five multidisciplinary experts, as well as other key stakeholders in the fight to reduce tobacco-related disease and death. This includes seven individuals who have served as president of the Society for Research on Nicotine and Tobacco. Drawing from our collective expertise, we write to petition the Centers for Disease Control and Prevention to rename “E-cigarette or Vaping Product Use-Associated Lung Injury” (EVALI). | This letter is signed by seventy-five multidisciplinary experts, as well as other key stakeholders in the fight to reduce tobacco-related disease and death. This includes seven individuals who have served as president of the Society for Research on Nicotine and Tobacco. Drawing from our collective expertise, we write to petition the Centers for Disease Control and Prevention to rename “E-cigarette or Vaping Product Use-Associated Lung Injury” (EVALI). | ||
==Studies / Papers== <!--T:5--> | |||
== | ===2022: [https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntac088/6562888 Exposure to Negative News Stories About Vaping, and Harm Perceptions of Vaping, Among Youth in England, Canada, and the United States Before and After the Outbreak of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’)]=== | ||
*Between 2017 and February–March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. By August 2020, exposure to negative news stories returned to 2019 levels, while perceptions of harm were sustained. | |||
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===2020: Sparking the Discussion about Vaping and Anesthesia: Comment=== <!--T:10--> | ===2020: [https://pubs.asahq.org/anesthesiology/article/133/4/948/108271/Sparking-the-Discussion-about-Vaping-and Sparking the Discussion about Vaping and Anesthesia: Comment]=== <!--T:10--> | ||
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The authors refer to an outbreak of 53 cases of e-cigarette and vaping–related lung injury, in which 84% of the cases admitted to the use of tetrahydrocannabinol products. The remaining 16% may have concealed the use of an illegal product, or not known what they were using. In those cases of e-cigarette and vaping–related lung injury where bronchoalveolar lavage was performed, 100% of the specimens were positive for vitamin E acetate, a dangerous contaminant in tetrahydrocannabinol oil. This outbreak is troubling but it is unrelated to the use of legal nicotine-based vaping products. | The authors refer to an outbreak of 53 cases of e-cigarette and vaping–related lung injury, in which 84% of the cases admitted to the use of tetrahydrocannabinol products. The remaining 16% may have concealed the use of an illegal product, or not known what they were using. In those cases of e-cigarette and vaping–related lung injury where bronchoalveolar lavage was performed, 100% of the specimens were positive for vitamin E acetate, a dangerous contaminant in tetrahydrocannabinol oil. This outbreak is troubling but it is unrelated to the use of legal nicotine-based vaping products. | ||
===2020: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151740/ Analysis of Cannabinoid-Containing Fluids in Illicit Vaping Cartridges Recovered from Pulmonary Injury Patients: Identification of Vitamin E Acetate as a Major Diluent]=== <!--T:12--> | |||
===2020: Analysis of Cannabinoid-Containing Fluids in Illicit Vaping Cartridges Recovered from Pulmonary Injury Patients: Identification of Vitamin E Acetate as a Major Diluent=== <!--T:12--> | |||
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There is additional evidence of a strong association of VEA with EVALI. In the initial analyses of bronchoalveolar lavage fluids from EVALI patients, 28 of 28 fluids contained vitamin E acetate. | There is additional evidence of a strong association of VEA with EVALI. In the initial analyses of bronchoalveolar lavage fluids from EVALI patients, 28 of 28 fluids contained vitamin E acetate. | ||
===2020: [https://www.nejm.org/doi/full/10.1056/nejmoa1916433 Vitamin E Acetate in Bronchoalveolar-Lavage Fluid Associated with EVALI]=== <!--T:14--> | |||
===2020: Vitamin E Acetate in Bronchoalveolar-Lavage Fluid Associated with EVALI=== <!--T:14--> | |||
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Pure THC oil has a viscosity like that of vitamin E acetate. Cutting THC oil with vitamin E acetate has been reported to be common in the illicit market. | Pure THC oil has a viscosity like that of vitamin E acetate. Cutting THC oil with vitamin E acetate has been reported to be common in the illicit market. | ||
===2020: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878297/ Association of vaping‐related lung injuries with rates of e‐cigarette and cannabis use across US states]=== <!--T:16--> | |||
===2020: Association of vaping‐related lung injuries with rates of e‐cigarette and cannabis use across US states=== <!--T:16--> | |||
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These findings are consistent with evidence linking | These findings are consistent with evidence linking the EVALI outbreak to vitamin E acetate and informally purchased or modified THC e‐liquids, as opposed to use of well‐established nicotine e‐cigarettes. | ||
===2019 - December 20: [https://www.nejm.org/doi/full/10.1056/NEJMoa1916433?fbclid=IwAR3Qt3IWJlBf3g3kW9RBWQJTza3CAMr0UsoRrFk3peCeEDX5wGooCAGkmBQ Vitamin E Acetate in Bronchoalveolar-Lavage Fluid Associated with EVALI]=== <!--T:18--> | ===2019 - December 20: [https://www.nejm.org/doi/full/10.1056/NEJMoa1916433?fbclid=IwAR3Qt3IWJlBf3g3kW9RBWQJTza3CAMr0UsoRrFk3peCeEDX5wGooCAGkmBQ Vitamin E Acetate in Bronchoalveolar-Lavage Fluid Associated with EVALI]=== <!--T:18--> | ||
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===2019: 2019 | ===2019: [https://ukhsa.blog.gov.uk/2019/10/29/vaping-and-lung-disease-in-the-us-phes-advice/ Vaping and lung disease in the US: PHE’s advice]=== <!--T:20--> | ||
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PHE has not changed its advice on nicotine containing e-cigarettes: Smokers should consider switching completely and vapers should stop smoking. | PHE has not changed its advice on nicotine containing e-cigarettes: Smokers should consider switching completely and vapers should stop smoking. | ||
The evidence still shows that vaping carries a small fraction of the risk of smoking. Using a nicotine-containing e-cigarette makes it much more likely someone will quit successfully than relying on willpower alone. But it’s important to use regulated e-liquids and never risk vaping home-made or illicit e-liquids or adding substances. | The evidence still shows that vaping carries a small fraction of the risk of smoking. Using a nicotine-containing e-cigarette makes it much more likely someone will quit successfully than relying on willpower alone. But it’s important to use regulated e-liquids and never risk vaping home-made or illicit e-liquids or adding substances. | ||
==Expert Testimony== <!--T:22--> | ==Expert Testimony== <!--T:22--> | ||
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==Suggestions to add to this page== <!--T:28--> | ==Suggestions to add to this page== <!--T:28--> | ||
===2023: [https://tobaccocontrol.bmj.com/content/32/e2/e255 Over 1 year later: smokers’ EVALI awareness, knowledge and perceived impact on e-cigarette interest]=== | |||
===2022: [https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-022-00694-6 Analysis of state portrayals of the risks of e-cigarette use and the cause of the EVALI outbreak]=== | |||
===2021: [https://www.ingentaconnect.com/contentone/trsg/trs/2021/00000007/00000002/art00004 Vitamin E Acetate is not Soluble in Nicotine E-liquids]=== | ===2021: [https://www.ingentaconnect.com/contentone/trsg/trs/2021/00000007/00000002/art00004 Vitamin E Acetate is not Soluble in Nicotine E-liquids]=== | ||
*[https://twitter.com/KozlovichS/status/1373116501130051587 Twitter thread] | *[https://twitter.com/KozlovichS/status/1373116501130051587 Twitter thread] | ||
===2021: [https://pubmed.ncbi.nlm.nih.gov/34694926/ Lessons Learned From the E-cigarette, or Vaping, Product Use-Associated Lung Injury (EVALI) Outbreak Response, Minnesota, 2019-2020]=== <!--T:29--> | |||
=== | ===2019 and Beyond: The CDC, the FDA, and others: EVALI=== | ||
*Article: [https://medium.com/the-great-vape-debate/the-cdcs-evali-screwup-ff09f4c3e187 The CDC’s EVALI screwup] | |||
**Making a mistake is one thing. Failing to correct it is worse. | |||
**But there is no evidence–none at all— that anyone got sick with EVALI from using e-cigarettes. | |||
*Twitter thread by [https://twitter.com/mikepesko/status/1468932559098757127 Mike Pesko] about the [https://drive.google.com/file/d/1o0mlqZaMMUeD7Eapc1H0CdSsTz4HsuxE/view letter to the CDC] requesting them to change the name of EVALI, and the CDC's [https://drive.google.com/file/d/13QvkPs5oK8MF_CWmO5SL9mCwUcTmFMwR/view refusal] to do so. This letter was signed by 75 international tobacco control / public health experts. | |||
*Paper: [https://www.ingentaconnect.com/content/aips/trs/2021/00000007/00000002/art00004 Vitamin E Acetate is not Soluble in Nicotine E-liquids] | |||
**Vitamin E acetate is not soluble in formulations of nicotine e-liquids and if mixed into a nicotine e-liquid will form a visibly distinct layer. Therefore, it is unlikely that nicotine-only e-cig users will be exposed to vitamin E acetate. | |||
*Paper: [https://www.qeios.com/read/ZGVHM7.3 The outbreak of lung injuries often known as "EVALI" was nothing to do with nicotine vaping] | |||
**An examination of the evidence shows that EVALI cannot have been caused by nicotine vaping. The characteristics of the lung injury outbreak are consistent with localised supply chain contamination. The contaminant has been identified and is known to be Vitamin E Acetate. This had been used as a thickener or cutting agent in illicit Tetrahydrocannabinol (THC) cannabis vape pens. This agent cannot be mixed with nicotine vaping liquids and would serve no useful purpose if it could be. | |||
*Article: [https://morningconsult.com/2020/02/05/electronic-cigarettes-increasingly-blamed-by-public-for-lung-illnesses-even-as-evidence-points-elsewhere/ E-Cigarettes Increasingly Blamed for Lung Illnesses, as Evidence Points Elsewhere] | |||
**CDC identified THC vapes with vitamin E acetate as culprit, but 66% of adults blame e-cigarettes for vaping deaths | |||
*Tweets by [https://twitter.com/ScottGottliebMD/status/1217893624353980416?s=20 Scott Gottlieb, MD] | |||
**An e-cigarette is an FDA regulated electronic nicotine delivery system (ENDS). It delivers nicotine. What CDC seems to be trying to refer to here are illegal vapes or “dabs” that contain THC. We develop precise regulatory nomenclature for a reason. It helps differentiate products | |||
**CDC should reconsider the name it ascribed to these illnesses (EVALI) now that it seems to be definitively linked to THC vapes and dabs. By not speaking with precision it could leave a false impression as to the clear causal relationship between the tragic illnesses and THC vapes | |||
**The public health risk is that kids using these illegal and dangerous THC products may not know that the CDC warnings relate to the THC products they’re using; since the CDC is not using a precise nomenclature to more clearly describe the THC vapes and dabs | |||
* Tweet by [https://twitter.com/ScottGottliebMD/status/1177704654068748293?s=20 Scott Gottlieb MD] | |||
**My point is simply if you know a THC product hurt someone, don’t call it an e-cigarette, call it a THC vape or THC vaping product. Nomenclature matters in helping consumers properly identify which products are causing which kinds of risks. That’s why we develop naming systems. | |||
==More Information== <!--T:30--> | ==More Information== <!--T:30--> | ||
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