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Public Health Uk: " The Usa Vape Epidemic does not appear to be associated with long term use of nicotine e-cigarettes.

Public Health Uk: " The Usa Vape Epidemic does not appear to be associated with long term use of nicotine e-cigarettes.

What’s happening in the US?


Since mid-September, headlines around the world have warned about an outbreak of serious lung disease across the US, said to be associated with vaping. As of October 22, 1,604 cases have been reported to the Center for Disease Control (CDC) from 49 US states, including 34 deaths.

The US has an estimated 9 million e-cigarette users in the country, but weekly updates on the CDC website make it clear that the group of people affected is very specific. The outbreak appears to be largely among young men: 70% of patients are male and the average age is 24. Almost half (46%) are under 21.

Dr Dana Meaney-Delman, head of the CDC team investigating the outbreak has reported that “We've narrowed this clearly to THC-containing products that are associated with most patients who are experiencing lung injury. The specific substance or substances we have not identified yet”. THC is the main psychoactive component of cannabis and the CDC has said that the products identified are being obtained off the street or from other informal sources (e.g. friends, family members or illicit dealers).

The specific chemical or chemicals that are causing the illness and deaths have not yet been identified and it is not clear that all cases are the same kind of injury. The outbreak does not appear to be associated with long term use of nicotine e-cigarettes, which have been used in the US for over 10 years. The first case was reported at the end of March this year and along with all the other cases appears to be linked with very recent use causing a rapid harmful effect.

Because of what’s happened, several US states have banned the use of flavourings in e-cigarettes and have called for urgent action.

Our concern is that the responses we have seen to the problem in the US and in other countries may increase the already widespread misunderstanding about the relative safety of nicotine e-cigarettes, deterring smokers from switching and risk driving vapers who have switched back to smoking. There is a real risk therefore that such a reaction will mean people continue to smoke, which will undoubtedly put lives at risk.

Could it happen here?

We need to be clear about what this outbreak is and is not. It is not a problem linked to long-term use of regulated nicotine vaping products. If it were, we would expect to see a very different demographic profile affected, more typical of long term vapers.

E-cigarettes containing nicotine are more tightly regulated in the UK than in the US and our medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for overseeing the tobacco regulations.

The main chemicals under suspicion in the US such as THC and Vitamin E acetate oil are not permitted in e-cigarettes in this country.

The MHRA operates the Yellow Card Scheme, where healthcare workers and members of the public can notify any health problems. Healthcare workers and the public can report a side effect or safety concern for e-cigarettes on the Yellow Card Scheme.

It’s also a similar situation across Europe, where there are similar restrictions on e-cigarettes as in the UK – under the European Tobacco Products Directive. No vaping related cases like in the US have been reported to the EMCDDA by its EU Early Warning System Network to date.

The illicit drugs market is global and it is possible that similar products to those in the US are available in the UK, which is why we are warning of this new and serious threat and continue to monitor carefully the situation in the UK.

PHE’s advice on e-cigarettes remains the same

PHE has not changed its advice on nicotine containing e-cigarettes: Smokers should consider switching completely and vapers should stop smoking.

We are as certain as ever that e-cigarettes are far less harmful than smoking, which kills almost 220 people in England every day.

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.

Vaping devices that do not include nicotine come under a different set of regulations, the General Product Safety Regulations. These are generally less stringent than the regulations covering nicotine containing e-cigarettes.

PHE advice on smoking and e-cigarettes

For smokers: You should stop smoking completely. Getting expert support combined with using an e-cigarette doubles your chances of quitting successfully. For the best way to quit read our advice

For people who vape nicotine: if you are still smoking, you should stop and switch completely to vaping, then come off nicotine when you are confident you won’t relapse to smoking.

If you have never smoked: Don’t vape.

For people who vape CBD: although CBD is less tightly regulated, if you experience symptoms or are concerned you should stop.

For people who vape THC: if you are vaping THC (or an unknown liquid which could contain THC) it can be hazardous. These are the products most implicated in the US outbreak. If you feel unwell or have any difficulty breathing after vaping THC, go to A&E and tell them precisely what the product was you were using.

We are monitoring the situation

We are keen to understand more about what is happening in the US, so we’re in regular contact with US federal agencies including the CDC, the Food and Drug Administration (FDA) and the National Institute on Drug Abuse (NIDA).

We are also working closely with our expert advisors on respiratory health and the MHRA.

The National Poisons Information Service records and analyses reports of poisoning. The rate of poisonings from e-cigarettes has remained stable. Cases of moderate or severe toxicity remain rare and associated with accidental and occasionally deliberate misuse and not with inhalation of nicotine.

We’re also continually updating the evidence on e-cigarettes. The government’s Tobacco Control Plan for England requires PHE to update its 2015 review of e-cigarettes and other novel nicotine delivery systems every year until the end of the current Parliament in 2022.

We are currently in the process of producing these reviews. The most recent one was published in February and focused on vaping prevalence and characteristics of e-cigarette use in adults and young people, and e-cigarette use in English stop-smoking services. The next review is due to be published in early 2020 and will include the latest analysis of use among young people.

We have updated our advice to the public, including on our FRANK website. We have not issued an alert to date. The evidence on the causes of the deaths in the US is not yet conclusive, the information has not reached the threshold to issue an alert and we continue to keep the issue under close review.

We have also cascaded information about nicotine-inhaling products to relevant local services, including local public health teams, stop smoking services and substance misuse services. This directs people to report any adverse effects to the MHRA’s Yellow Card Scheme.

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US crisis, CDC investigations: field limited to products containing Thc

US crisis, CDC investigations: field limited to products containing Thc

US crisis, CDC investigations: field limited to products containing Thc


"We have clearly restricted the field to products containing Thc, which are associated with most patients with lung lesions. We have not yet identified the specific substance or substances, but even when we do it will not be something that will necessarily help to inform the public. " To explain the progress of the investigation into the outbreak of lung diseases is Dr. Dana Meany-Delman, head of the emergency unit of the Centers for disease control and prevention (Cdc) which is dealing with the case. It does this to Public Health Readio microphones, answering a specific question about the causes of the sudden explosion of cases. Much of the work of the team of epidemiologists, communication experts, laboratory technicians and doctors coordinated by Meany-Delman, consists in systematizing the data coming from the single States of the USA. And in all, so far, we highlight the preponderance of the use of electronic cigarette cartridges containing Thc, mostly purchased or found for illegal channels.


Therefore, as Dana Meany-Delman says, it is quite clear that the problem originates in the products containing Thc and she herself remembers that the CDC managed to carry out an effective AIDS prevention campaign, well before having identified the virus that it caused the disease. Perhaps at the moment there are enough elements to launch a clear and unequivocal alarm and not, as the Michigan health authorities do, continue to "urge citizens not to use electronic cigarettes or vaping products, in particular those containing THC". Continuing to bring up an instrument that helps people quit smoking does not serve public health well.

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The pneumologist Lowenstein: "No potential toxicity in the electronic cigarette"

The pneumologist Lowenstein: "No potential toxicity in the electronic cigarette"

"We absolutely must reassure electronic cigarette users". This is the concern expressed by the French doctor William Lowenstein who, having returned from a round table at the Sommet dé la vape, gave an important interview to the Breton newspaper Le Télégramme. Pulmonologist, specialist in internal medicine and president of Sos Addiction (a medical association that deals with the fight against addiction, Lowenstein is keen to shed light on the crisis of polomary diseases, the so-called Evoli, in the United States. “It is not the instrument that causes the deaths - he explains - is the liquid, an oil with cannabis. Some States of the USA, which have not applied any regulation on the subject, have suddenly taken refuge in the prohibitionist regime. "And then he adds:" But it is something that does not it could never happen in France or in Europe ”. 

Because, the doctor explains, France immediately severely regulated the vaping sector and it is not possible to market liquids without first being deposited, evaluated and verified by the drug and food regulatory agency (Anses) . As is the case throughout Europe. Lowenstein also rejects the thesis that there are not enough scientific studies on the electronic cigarette. "It is false - he says - it has been studied for ten years. There are completely reliable research conducted in the United States, Great Britain, France and elsewhere ". And he adds that it has been known for a long time that neither nicotine nor tobacco per se are the killers of traditional smoke. "It is the burning of tobacco - he explains - that emits carbon monoxide (which causes vascular problems) and that of paper that generates tar and benzopyrene". "In the vaping - he underlines - there is no potential toxicity".

Lowenstein's latest critical words are for the World Health Organization, which last July published a report on tobacco that called the electronic cigarette "unquestionably harmful". Meanwhile, the French doctor points out, the report was not drafted by the WHO, but by Bloomberg Philantrhopies, ie by a private foundation. As evidenced also on these columns, the study consisted of 200 pages, four of which were dedicated to the electronic cigarette, "and they didn't really speak badly about it", adds Lowenstein. "Then - he comments - in a final sentence, it is classified as harmful. In France, the academies of medicine, pharmacy and numerous specialists have become indignant about this incomprehensible position! ".


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FDA Warns: "Don't Use THC Containing E-Liquids

FDA Warns: "Don't Use THC Containing E-Liquids

"Don't use vaping products containing Thc. Do not use products - in particular containing Thc - purchased on the street or obtained from other illegal or social sources. Do not modify or add substances of any kind, such as Thc or other oils, to vaping products ”. More than three months after the outbreak of the pulmonary crisis and with the numbers of suspected or confirmed cases continuing to grow (although some are hospitalizations that took place in recent months and were brought back only after the event), the Food and Drug Administration has deemed it to be having to launch a clearer and clearer warning for the protection of citizens. In the announcement published on October 4, the agency clearly warns against the use of electronic cigarette products containing tetrahydrocannabidiol (Thc, the psychoactive substance of cannabis) and any vaping product purchased for illicit channels.

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Melania Trump  Wants The European Sale Model: Ban Minor Sales And Sober Packaging

Melania Trump Wants The European Sale Model: Ban Minor Sales And Sober Packaging

She chose an anti-drug event organized by Dean Norris, actor of Breaking Bad, to launch yet another appeal on the electronic cigarette. Melania Trump has been riding the subject for some weeks now. One even thinks that the interest of President Trump is derived just after his wife's suggestion. "It is important - said Melania - that we all work to educate children and families about the dangers.  The first lady then pointed out that she had already warned her son Barron, 13, to "stay away from vape".

The suggestions of Melania Trump, in honor of the truth, have a fund of truth. The electronic cigarette is not intended for young people or even for non-smokers. It is a device that delivers nicotine, reducing the risks of tobacco combustion. But while in the United States at the moment there are no rules - and the debate has just begun - Europe has a special legislation since 2014. The two arguments presented by Melania would have no value here where we are the prohibition of sales to minors under 18 and the prohibition of affixing images in the packaging that recall food products and sweets IN NICOTINE CONTAINING  products, as imposed by the EU directive on tobacco and liquid inhalation products.


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Austrian Lab Analyzes - Dea E-Liquids Vs Cigarettes

Austrian Lab Analyzes - Dea E-Liquids Vs Cigarettes

Liquids for electronic cigarettes, Dea Flavor starts the transparency operation

Published toxicological analyzes carried out by the Austrian Drug Screening Institute of Innsbruck in collaboration with 3SLAB and comparison with traditional cigarettes.


Do electronic cigarettes pose health risks? The debate has been open for years, with even conflicting positions. If on one hand the potential health risks that can still occur if products of dubious derivation are not diminished, on the other hand the consistent reduction of the damage compared to traditional smoking cannot be ignored. For this reason, Dea Flavor, one of the major Italian companies producing liquids for electronic cigarettes, commissioned a study on the toxicity of its liquids carried out on human cells in vitro. The analyzes were carried out at the Austrian Drug Screening Institute in Innsbruck, with the collaboration of 3SLAB, and the results obtained confirm a well-established scientific data: the e-cig vapor involves a damage reduction of about 95% compared to to traditional cigarette smoking. Dea Flavor has analyzed all its premixed liquids at the maximum concentration of nicotine - or 18 mg / ml - by vaporizing them thanks to a smoking machine. The vapors thus obtained were then condensed in the laboratory for sample preparation. A similar procedure was performed for the condensation of traditional cigarette smoke.

Following the protocols reported in the scientific literature, the different samples were placed in contact with human endothelial cells to verify the effects of electronic cigarette condensate and traditional cigarette condensate. The analyzed effects are essentially two: deadly effect (the percentage of an enzyme that is released as a result of cell lysis, that is the death of the cell is measured) and toxic effect (the metabolism of a cell is monitored, to understand how much it is influenced by the 'exposure to vapors of electronic cigarettes and how much from smoke). All measurements were performed three times in order to guarantee the repeatability and reliability of the data. To analyze the first effect, we quantify the amount of lactate dehydrogenase (LDH), an enzyme that is formed as a result of cell lysis, that is the death of the cell, after interaction with the samples: in this case the higher is the data obtained, the higher the cell mortality. The results left no room for doubt: the negative effect on the cells is much lower in Dea liquid vapor compared to traditional smoke (table 1 at the end of the article). To assess the toxic effect on cells, the cyto-toxic impact on cellular metabolism, or on the ability of cells to regenerate themselves, compared to traditional cigarette smoking, through the quantification of Resazurin was instead analyzed. In this case the percentage of cells that, following exposure to the samples, have not undergone metabolic alterations is shown, therefore the greater the data obtained, the lower the danger of the tested product (table 2 at the bottom of the article) . Compared to traditional cigarette smoking, the cytotoxicity of Dea Flavor products is significantly lower.

"The evaluation of both these factors - explains cotitolare Daniele Campestrini (on the left in the picture) - is carried out by Dea Flavor during the research and development phase of all the new products, which can be placed on the market only if they comply with these rigid internal quality standards. We have always strived to guarantee our customers a safe product right from the selection of raw materials that are used in the preparation of liquids for electronic cigarettes, using only pharmaceutical or food grade products. Precisely for this reason, the Dea Flavor team has developed a blacklist of prohibited substances that cannot be used in our products that is constantly updated on the basis of the most recent scientific research, in order to exclude from the ingredients those substances that could present potential dangers for Health".


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