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 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.


=Is Popcorn Lung the same thing as EVALI?=
=Is Popcorn Lung the same thing as EVALI?=
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=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.
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.


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."  
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."
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."


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 [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].  
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."


A chemical of concern that might pose potential harm swiftly morphed into known harm, and word began to 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.
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."
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."
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=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.
*Many e-liquid manufacturers switched to Diacetyl-free ingredients.
*Most flavor [https://shop.perfumersapprentice.com/t-FlavorWorkshopCustard.aspx manufacturers] reformulated their flavoring to Diacetyl-free formulas.
*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).
*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]
*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]
*Dec 14, 2021 - Cancer Research UK - [https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/does-vaping-cause-popcorn-lung Does vaping cause popcorn lung?]
*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?=
July 16, 2019 - Competitive Enterprise Institute - [https://cei.org/blog/bogus-e-cigarette-panic-literally-killing-people/ Bogus E-cigarette Panic Literally Killing People]
*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]
*August 8, 2016 - Snopes.com - [https://www.snopes.com/fact-check/vaping-causes-popcorn-lung/ Vaping Causes 'Popcorn Lung'?]
*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 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”]


=Who has corrected or deleted their incorrect information on Popcorn Lung?=
=Who has corrected or deleted their incorrect information on Popcorn Lung?=
*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]
*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.  
*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.  
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[[File:Harvard Health Tweet.png|center]]
[[File:Harvard Health Tweet.png|center]]
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=Who's information can lead people to believe that vaping causes Popcorn Lung?=
=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 vaping.
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 vaping.
*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
*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
*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 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]
*American Lung Association [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)
*American Lung Association [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)
*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] - Feb 20, 2024
*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) ('''NOTE compare this version with the current one to see if the same)
*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
*Harvard Health Publishing - Popcorn lung: What is it, and who is at risk? (which was changed - more 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])
*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]
*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] - February 23, 2024 [https://twitter.com/htlifeandstyle/status/1760913850155573668 Tweet]
*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
*International Journal of Pharmaceutical, Chemical and Biological Sciences (IJPCBS) [https://www.ijpcbs.com/abstract/popcorn-lung-the-edisease-78162.html POPCORN LUNG: THE E-DISEASE] - 2021
*John 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)
*Parkview Health - [https://www.parkview.com/blog/e-cigarettes-know-the-risks E-cigarettes: Know the risks] - Nov 9, 2023
*PharmEasy - [https://pharmeasy.in/blog/does-vaping-cause-cancer-exploring-the-health-implications/ Does Vaping Cause Cancer? Exploring The Health Implications] - Feb 14, 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
*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
*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
*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
*[https://documents1.worldbank.org/curated/en/356561555100066200/pdf/E-Cigarettes-Use-and-Taxation.pdf World Bank Group Global Tobacco Control Program] 2019
*[https://documents1.worldbank.org/curated/en/356561555100066200/pdf/E-Cigarettes-Use-and-Taxation.pdf World Bank Group Global Tobacco Control Program] 2019
*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://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]
Line 62: Line 136:
**[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://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]
**[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]
*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]
('''To Do List - SAVE all links on Wayback''')


=Addendum=
=Addendum=

Latest revision as of 11:13, 26 April 2024



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.

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 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 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 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 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 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 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.

A chemical of concern that might pose potential harm swiftly morphed into known harm, and word began to spread that vaping causes Popcorn Lung, even though there were no documented cases of it actually occurring. A 2015 report published in the 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 information about Popcorn Lung and vaping on their website in 2016.

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 attempt to keep teens safe and discourage them from experimenting with vaping began telling 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 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 commentary about 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?



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 vaping.

(To Do List - SAVE all links on Wayback)

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.

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