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Articles of Interest: Electronic Nicotine Delivery Systems

The vape pen was supposed to improve Adam's life.
A teen's injuries looked like he was in a "high speed" crash. Instead, a vape pen exploded in his mouth.
The Washington Post

2019

Recently, I was approached on London Bridge by an attractive sales woman with samples of what looked like sweet containers. On closer inspection, they were not confectionary, but instead turned out to be nicotine vape samples. I was not asked if I was over 18 (I look young for someone in their mid-20s), and I was not asked if I was trying to quit smoking or had a previous history of substance abuse. I politely declined.

The marketing for nicotine vapes around the world has been, by and large, poorly regulated, and it is commonplace in London to see teenagers with their hands on vapes blowing pillows of smoke. While 10 years ago it would have been more common to see teenagers experimenting with their first cigarettes under the cover of trees and park benches, the seemingly more accessible nature of vapes has started to replace this underage rite of passage with something more blatant. In the United States, the Federal Court has launched an investigation into Juul, a large nicotine vape producer. The global regulation of vaping, which contains nicotine, a substance found to be nearly as addictive as heroin, should be more common than it is now.

"Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping." Centers for Disease Control and Prevention, September 19, 2019.
  • There are 530* cases of lung injury reported from 38 states and 1 U.S. territory. Seven deaths have been confirmed in 6 states.
  • CDC has received complete sex and age data on 373 of 530 cases.
    • Nearly three fourths (72%) of cases are male
    • Two thirds (67%) of cases are 18 to 34 years old
    • 16% of cases are under 18 years and 17% are 35 years or older
  • All reported cases have a history of e-cigarette product use or vaping.
  • Based on initial data from certain states we know: Most patients have reported a history of using e-cigarette products containing THC. Many patients have reported using THC and nicotine. Some have reported the use of e-cigarette products containing only nicotine.

Today, the Trump Administration announced that as part of its ongoing work to tackle the epidemic of youth e-cigarette use, the FDA intends to finalize a compliance policy in the coming weeks that would prioritize the agency’s enforcement of the premarket authorization requirements for non-tobacco-flavored e-cigarettes, including mint and menthol, clearing the market of unauthorized, non-tobacco-flavored e-cigarette products. The FDA plans to share more on the specific details of the plan and its implementation soon.

Within days, Alexander Mitchell had gone from being a 20-year-old hiking enthusiast to being kept alive by two machines forcing air into and out of his lungs and oxygenating his blood outside of his body.

Sun, Lena; Lindsey Bever. "Mystery lung illness linked to vaping. Health officials investigating nearly 100 possible cases.." The Washington Post, August 16, 2019.

State and federal health officials are investigating almost 100 cases of mysterious lung illnesses linked to vaping and e-cigarette use in 14 states, many of them involving teens and young adults. A large number of those stricken ill have been hospitalized, with some in intensive care and on ventilators.

Chris Sweeney. "The problem with industry-sponsored vaping research." Harvard T.H. Chan, August 16, 2019.

Use of e-cigarettes and other vaping products including Juul is soaring, especially among youths. Between 2017 and 2018, the prevalence of current e-cigarette use among U.S. high school students increased from 12% to 21%. Andy Tan, assistant professor of social and behavioral sciences, recently co-authored a Lancetarticle examining how Juul is funding scientific research—and why this is problematic.

Frieden, Joyce. "Vaping Companies Marketing to Teens, House Panel Told." MedPage Today, July 24, 2019.

WASHINGTON -- Children and teenagers should not be vaping, House members and witnesses agreed at a hearing Wednesday, but they disagreed on what government should focus on regarding e-cigarettes such as those made by JUUL: their potential as smoking-cessation aids for adults, or their role in creating a new generation of nicotine addicts.

Kempe, Yaabelle. "E-cigarette users seeking help in lonely struggle to quit vaping." Boston Globe, July 7, 2019.

Kyle, a rising senior at BU, has tried to quit vaping. His last attempt was unsuccessful and he found himself switching to Smok Novo (above) instead of Juul.

Connor hated feeling like a slave to the slender metal device in his pocket. That’s why the rising junior at Boston College recently wrote his first-ever Reddit post on the page “QuittingJUUL,” a virtual space populated by more than 800 others who are also battling e-cigarette addiction.

Boyles, Salynn. "Big Study to Explore Long-Term Impact of Vaping, Pollution." MedPage Today, June 21, 2019.

The long-term impact of vaping on the lungs and the impact of early-life air pollution exposures will be among the key focuses of a first-of-its kind federally funded, longitudinal study of lung health among millennials.

Researchers from Northwestern Medicine in Chicago, in partnership with the American Lung Association, plan to follow 4,000 healthy adults from the ages of 25 to 35 in an effort to gain further insights into the causes of chronic respiratory diseases common in later life.

When the 17-year-old boy arrived at Primary Children’s Hospital in Salt Lake City, his entire jaw was cracked and a chunk of the bone had been completely shattered. Several of his teeth were missing and there was a hole in his chin.

Glimcher, Laurie H.. "Ending the Long Reach of Tobacco." The Boston Globe, June 13, 2019.

Many of us know someone whose life was cut short by tobacco, and their stories are heartbreaking. What makes them even more so is that, in many cases, it didn’t have to happen. As the leading cause of preventable death, smoking causes 1 in 5 of all deaths in the United States, totaling more than 480,000 annually. Tobacco is also linked to about one-third of all cancers in the United States, including cancers of the pancreas, bladder, kidney, mouth, and throat, as well as the lung. Even with all of the recent advancements in cancer research and care, these remain some of the most lethal and difficult cancers to treat.

Nackerdien, Zeena. "E-Cig Flavors May Damage Cardiovascular Cells." MedPage Today, June 6, 2019.

One of the risk factors for cardiovascular (CV) diseases is smoking-induced endothelial dysfunction. Joseph C. Wu, MD, PhD, of the Stanford School of Medicine in California, and colleagues used iPSC-ECs to assess the health impact of e-cigarettes. By definition, these cells can become many different cell types, and therefore provided investigators with a means to study cells that would be hard to isolate from any given patient.

It’s not that often that you hear a top Trump official unabashedly blaming a US company for a health crisis. But that’s exactly what FDA chief Scott Gottlieb did Tuesday in an interview during his final week in office.

Boyles, Salynn. "Survey of Adults' Perceptions of E-Cig Safety Yields Surprise." Med Page Today, March 29, 2019.

Adults in the U.S. increasingly think electronic cigarettes are as harmful as combustible cigarettes, if not more so, according to findings from two multiyear national surveys.

Maloney, Jennifer. "FDA Sets Limits on Retail Sales of Flavored E-Cigarettes." Wall Street Journal, March 13, 2019.

Convenience stores and gas stations will effectively be banned from selling most flavored e-cigarettes under restrictions issued Wednesday by the Food and Drug Administration.

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