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New Mayo Clinic Study Further Implicates Contaminated THC Oils in Respiratory Disease Outbreaks and Refutes Claim that Store-Bought Nicotine E-Liquids are Involved

study published yesterday in the New England Journal of Medicine by a team of researchers at the Mayo Clinic provides further evidence that contaminated THC oils are likely playing a major role in the vaping-associated respiratory disease outbreak and makes it even less likely that store-bought nicotine e-liquids are playing any role at all. Here is the key evidence provided by the paper: 1. The overwhelming majority of patients admitted to vaping THC oils. Approximately 76% of the patients studied who reported on product use admitted to vaping marijuana (13 out of 17 patients). Because urine THC testing was either not conducted or not reported, it is not possible to state that any of these cases occurred in a patient who had not vaped a marijuana-based product. In one case, a patient had been vaping nicotine e-liquids for five years, but then tried vaping marijuana and was in the hospital with respiratory distress within a few days. His vaping history was reported as: "vaping nicotine for 5 years; on weekend prior to presentation, started vaping nicotine with marijuana for the first time." 2. The study authors suspect a direct chemical injury to the lungs, suggesting that a new contaminant, not traditional nicotine e-liquids, is the most likely cause. After examining the lung biopsies, the authors concluded that the most likely explanation for these cases is "direct lung toxicity from an inhaled noxious agent or agents." The ingredients of store-bought nicotine e-liquids is quite standard. These e-liquids contain propylene glycol, glycerin, water, nicotine, and flavorings. This formula is ubiquitous for all store-sold nicotine e-liquids and there have not been any recent changes to these ingredients. The FDA's testing of the recovered nicotine e-liquids from case patients have so far not revealed any contaminants. These products have been sold for years without reported problems of lung toxicity. In contrast, black market THC products and counterfeit vape cartridges sold over the internet and by street dealers are very susceptible to contamination. Unlike legal THC oils, the black market products are not tested, and therefore might contain pesticides, residual solvents, other noxious chemicals, or synthetic cannabinoids, each of which could potentially cause a direct chemical injury to the lung. In fact, acute respiratory toxicity from synthetic cannabinoids has been observed. So has acute alveolar hemorrhage and a more subacute lung injury characterized radiographically by diffuse hazy densities. Moreover, just lack week, testing of a large number of black market THC vape cartridges revealed that they "all contained myclobutanil, a fungicide that can transform into hydrogen cyanide when burned," which can have severe respiratory toxicity. It was also recently shown that vaping butane hash oil can result in severe lung toxicity that presents in a similar fashion to the current outbreak cases. 3. The study findings are not necessarily inconsistent with lipoid pneumonia. Although the study authors opine that the pathological findings are not indicative of exogenous lipoid pneumonia, the basis for this conclusion is not clear. The authors' assertion seems to be based primarily on their failure to find "coalescent of lipid into large droplets." However, there are many previous reports of exogenous lipoid pneumonia in which the pathology examination did not report finding a coalescence of lipid into large droplets in the lung. The main finding in these previous studies (example) was the presence of lipid-laden macrophages, just as the primary finding in the current study was the presence of foamy (lipid-laden) macrophages. The radiographic findings in many of the cases and the finding of lipid-laden macrophages are consistent with a diagnosis of lipoid pneumonia in at least some of the observed cases. I think it is premature to rule out the significance of the inhalation of large quantities of viscous oil in the pathogenesis of the disease. The results of this study add to the growing evidence that contaminated black market THC oils or counterfeit, bootleg vape cartridges are the primary, if not sole, cause of the outbreak. In two cases, legally purchased THC oils from dispensaries in Oregon were implicated. However, there are no cases that have been shown to be associated with the use of store-purchased nicotine e-liquids and it seems extremely unlikely that these products have any involvement in the outbreak.   *This article was not written by Maxed Out Vape Written the Michael Siegel 10/3/2019 https://tobaccoanalysis.blogspot.com/2019/10/new-mayo-clinic-study-further.html?m=1&fbclid=IwAR1XNtFquIWItE8n3iQC6mnAcxiewAAaicof6tw5yLbjTKm6BebSCbqk_RM

Public Health Expert On E-cigarette Panic

Researchers are working hard to determine the cause of more than 500 reported cases of lung illness affecting e-cigarette users. But even before this outbreak, e-cigarettes divided the medical community. Public Health England describes e-cigarettes as "at least 95% less harmful than tobacco cigarettes" – a claim New York University professor David Abrams agrees with. Abrams tells "CBS This Morning" Tony Dokoupil why he's concerned about what the current panic about e-cigarette safety could mean for public health. *This article was not written by Maxed Out Vape Written the CBS NEWS 9/20/2019 https://www.cbsnews.com/video/public-health-expert-worries-e-cigarette-panic-is-ruining-single-biggest-public-health-opportunity-in-120-years/?fbclid=IwAR3uqjWpNfS5a1GL_H_P1ZH250ECXKN1RiPk4IS_YfTajxIVw9AMv9u2TKM

FDA Warns Public to Stop Using Tetrahydrocannabinol (THC)-Containing Vaping Products and Any Vaping Products Obtained Off the Street


  • Consumers and family members of consumers who use vaping products containing tetrahydrocannabinol (or THC), a psychoactive component of the marijuana plant.
  • Consumers who have used vaping products of any kind obtained off the street or from unknown sources.
  • Consumers experiencing symptoms such as cough, shortness of breath or chest pain after using vaping products.
  • Health care professionals treating patients who use vaping products.


In its continued efforts to protect the public, the U.S. Food and Drug Administration (FDA) is strengthening its warning to consumers to stop using vaping products containing THC amid more than 1,000 reports of lung injuries—including some resulting in deaths—following the use of vaping products. The FDA is working closely with the U.S. Centers for Disease Control and Prevention (CDC), as well as state and local public health partners to investigate these illnesses as quickly as possible. While the work by federal and state health officials to identify more information about the products used, where they were obtained, and what substances they contain is ongoing, the FDA is providing members of the public with additional information to help protect themselves.

Problem and Scope:

A majority of the samples tested by the states or by the FDA related to this investigation have been identified as vaping products containing THC. Through this investigation, we have also found most of the patients impacted by these illnesses reported using THC-containing products, suggesting THC vaping products play a role in the outbreak.

Recommendations for the Public:

  • Do not use vaping products that contain THC.
  • Do not use vaping products—particularly those containing THC—obtained off the street or from other illicit or social sources.
  • Do not modify or add any substances, such as THC or other oils, to vaping products, including those purchased through retail establishments.
  • No vaping product has been approved by the FDA for therapeutic uses or authorized for marketing by the FDA. The agency recommends contacting your health care provider for more information about the use of THC to treat medical conditions.
  • No youth or pregnant women should be using any vaping product, regardless of the substance. Adults who do not currently use tobacco products should not start using these products. If you are an adult who uses e-cigarettes instead of cigarette smoking, do not return to smoking cigarettes.
  • If you choose to use these products, monitor yourself for symptoms (e.g., cough, shortness of breath, chest pain) and promptly seek medical attention if you have concerns about your health. If you are concerned about your health after using a vaping product, contact your health care provider, or you can also call your local poison control center at 1-800-222-1222. Health care providers also can contact their local poison control center.

FDA Actions:

More information is needed to better understand whether there is a relationship between any specific products or substances and the reported illnesses. To help gather and analyze as much information as possible, the FDA is working closely with federal and state partners to identify the products or substances that may be causing the illnesses. The FDA’s Forensic Chemistry Center is using state-of-the-art technology to analyze hundreds of samples submitted by a number of states for the presence of a broad range of chemicals, including nicotine, THC, other cannabinoids, and opioids along with cutting agents/diluents and other additives, pesticides, poisons, heavy metals and toxins. No one substance has been identified in all of the samples tested. Importantly, identifying any compounds that are present in the samples will be one piece of the puzzle but will not necessarily answer questions about what is causing these illnesses. Federal and state partners are following any potential leads. The FDA is committed to taking appropriate actions as the facts emerge and keeping the public informed as we have more information to share.

How to Report a Problem:

CDC and the FDA encourage the public to provide detailed information related to any unexpected tobacco- or e-cigarette-related health or product issues to the FDA via the online Safety Reporting Portal *This article was not written by Maxed Out Vape Written the FDA 10/4/2019 https://www.fda.gov/consumers/consumer-updates/vaping-illness-update-fda-warns-public-stop-using-tetrahydrocannabinol-thc-containing-vaping

New Steps To Address Epidemic of Youth E-Cigarette Use

More than a year ago, the FDA unveiled a broad policy to reduce the death and disease caused by smoking. Smoking remains the number one preventable cause of death in America, killing nearly half a million people a year. If we aren’t successful in more sharply reducing the rate of addiction to tobacco, then we’ll continue to see this needless death and disease. FDA’s new legal authorities to regulate tobacco ‒ as part of the Tobacco Control Act ‒ empowered us to alter this trajectory. We saw an opening to push a generational shift in the deadly course caused by tobacco. And we’ve seized it. Our comprehensive tobacco plan to combat the ill effects of smoking was founded on a central animating principle. That what primarily causes death and disease from tobacco use isn’t the nicotine in these products. It’s the act of lighting tobacco on fire to free that drug for inhalation. While it’s the addiction to nicotine that keeps people smoking, it’s primarily the combustion, which releases thousands of harmful constituents into the body at dangerous levels, that kills people. This fact represents both the biggest challenge to curtailing cigarette addiction ‒ and also holds the seeds of an opportunity that’s a central construct for our actions. E-cigarettes may present an important opportunity for adult smokers to transition off combustible tobacco products and onto nicotine delivery products that may not have the same level of risks associated with them. So, we set out on a new rulemaking process that seeks to regulate the nicotine levels in combustible cigarettes to render them minimally or non-addictive. That process is well underway. And at the same time, we’re developing a path to properly regulate non-combustible forms of nicotine delivery, like electronic cigarettes, that may be an alternative for adults who still want to get access to satisfying levels of nicotine, without all the risks associated with lighting tobacco on fire. We saw an important opportunity. We saw a chance to leverage the potential benefits of new and non-combustible technology to allow more adults to get nicotine from sources that could pose a lot less harm than smoking cigarettes. We continue to believe in this central concept. But let me be clear that nicotine isn’t a benign substance. This is especially true when it comes to children, and the effects that nicotine has on a developing brain. That’s why we need a strong regulatory process that puts these new products through an appropriate series of regulatory gates. We need a regulatory process that requires product applications to show that the marketing of the product is appropriate for the protection of the health of the overall population. And we need a regulatory process that keeps these same electronic cigarette products out of the hands of youth. This is our current policy framework to fulfill a central premise of our public health mandate. We need to make sure that we properly evaluate the net public health impact of products like e-cigs before they get marketing authorization from the FDA and that these products meet their regulatory responsibilities. Such products may still pose health risks, including possibly releasing some chemicals at higher levels than conventional cigarettes, and these potential risks require closer scrutiny. But since electronic nicotine delivery system (ENDS) products had only been recently brought under FDA’s regulatory jurisdiction, few of the foundational rules and guidance documents for defining and clarifying the premarket authorization process for such products had been established at the time I joined the FDA 17 months ago. So, to create this regulatory framework for how we’d properly evaluate the electronic nicotine delivery products, we’ve committed to the development of guidance and regulations, including product standards, that will better spell out the rules of the road. And we’re making significant progress toward achieving these procedural goals. If we succeed in our overall plan, the public health impact can dwarf anything else we’re able to accomplish in any reasonable stretch of time. It can dwarf the introduction of any new medical technology. Analysis shows that our plan has the potential to drop smoking rates from the current 15 percent to as low as 1.4 percent. It can prevent more than 33 million people ‒ including children ‒ from becoming smokers; avoiding a lot of the death and disease that’s going to be caused by cigarettes. Yet despite our progress, and these metrics, we find ourselves at a very challenging crossroads in the execution of this plan. That’s because we didn’t foresee the extent of what’s now become one of our biggest challenges. We didn’t predict what I now believe is an epidemic of e-cigarette use among teenagers. Today we can see that this epidemic of addiction was emerging when we first announced our plan last summer. Hindsight, and the data now available to us, reveal these trends. And the impact is clearly apparent to the FDA. Unfortunately, I now have good reason to believe that it’s reached nothing short of an epidemic proportion of growth. I use the word epidemic with great care. E-cigs have become an almost ubiquitous ‒ and dangerous ‒ trend among teens. The disturbing and accelerating trajectory of use we’re seeing in youth, and the resulting path to addiction, must end. It’s simply not tolerable. I’ll be clear. The FDA won’t tolerate a whole generation of young people becoming addicted to nicotine as a tradeoff for enabling adults to have unfettered access to these same products. This fundamental commitment is why FDA launched our Youth Tobacco Prevention Plan earlier this year. That plan encompassed a series of actions to stop youth use of tobacco products, especially the rising use of e-cigarettes. Our Youth Tobacco Prevention Plan focuses on three key strategies. First, preventing youth access to tobacco products. Second, curbing the marketing of tobacco products aimed at youth. And finally, educating teens about the dangers of using any tobacco products. Recognizing that our most immediate tool to address youth use is enforcement, this has been a cornerstone of our approach. And it’s a tool that we’ll continue to deploy, and with growing vigor, to directly address this challenge. We’ve taken a series of compliance actions over the past year. In partnership with the Federal Trade Commission, we targeted misleadingly labeled or advertised e-liquids resembling kid-friendly foods like juice boxes, candy and cookies. Since then, the manufacturers, distributors, and retailers that were warned by the FDA have stopped selling products with the offending labeling and advertising. And, today, the FDA issued 12 warning letters to other companies that continue to advertise and sell the violative products. This includes several companies that are also cited by the FDA for illegally selling the products to kids. We’ve also sharply expanded our enforcement against retailers who illegally sell e-cigarettes to kids. This spring, we focused on sales of JUUL, issuing 56 warning letters and six civil monetary penalties to retailers as part of this effort. And, today, we’re announcing that we’re taking other, significant enforcement and compliance actions. We’re announcing the largest ever coordinated initiative against violative sales in the history of the FDA. This is the largest single enforcement action in agency history. It’s aimed at retail and online sales of e-cigarettes to minors. We sent more than 1,100 warning letters to stores for the illegal sale of e-cigarettes to minors. In addition, we issued another 131 civil money penalties to stores that continued to violate the restrictions on sales to minors. But we must do more to stem what I see as an epidemic of use of e-cigs among teens, and deeply disturbing trends that show no sign of abating. So, we’re also going to re-visit the compliance policy that we announced last summer to extend the application compliance periods for certain deemed products, including and especially the e-cigarettes that were on the market as of Aug. 8, 2016. Under the current policy, the compliance date for filing applications for such products was extended to Aug. 8, 2022. We exercised that discretion for ENDS products because, as part of the tobacco and nicotine regulatory framework that we developed, which includes pathways to transition smokers off combustible cigarettes, we wanted to allow time for FDA to establish and more clearly explain the series of appropriate regulatory gates ‒ and for companies to prepare quality applications for new products like e-cigarettes. That’s where the e-cigarettes and other non-combustible products come into play. We wanted to make sure ‒ before we began enforcement of the application requirements ‒ that there was a clear, viable pathway to seek FDA authorization to market alternative products for adult smokers who still sought access to nicotine. But in view of the accelerating use among youth, we’re actively considering whether we will enforce the premarket review provision earlier, when it is apparent that these products are now subject to widespread youth use. One factor we’re closely evaluating is the availability of characterizing flavors. We know that the flavors play an important role in driving the youth appeal. And in view of the trends underway, we may take steps to curtail the marketing and selling of flavored products. We’re now actively evaluating how we’d implement such a policy. I’ve spent a lot of time considering whether there were different choices we could have made last summer that would have lessened, or avoided, the epidemic of youth use that I believe is before us. As stewards of public health, this is an important question that we must ask ourselves as we consider what steps to take at this challenging crossroads. For instance, what if we hadn’t extended the compliance dates for filing applications for e-cigs on the market when the deeming rule went into effect? In reality, most of those applications wouldn’t have been submitted until last month. And the e-cigs would have remained on the market for at least an additional year while we reviewed them. So, products would’ve still been on the market, and we might still have had the disturbing trends gripping us now in 2018. When we set that comprehensive plan in motion, we also knew we didn’t have all the regulations and guidance that we wanted in place to more clearly define the application pathway for these non-combustible alternatives. While the statute places the burden on manufacturers to show with scientific evidence that the public health standards in the law are met, we also understood that many manufacturers were new to regulation. And many novel products were already on the market. Given the circumstances, we felt that it was important to provide clear, transparent, and predictable rules of the road for industry. And so, for these reasons, we wanted to give the e-cig industry time to come into compliance while we wrote the guidance and regulations to better define and explain how the new products would meet those application requirements. It was an exercise in good government that was taken to accommodate the continued availability of innovations that we believe have potential value. But our public health mandate to prevent youth addiction has forced us to now revisit this element of our overall plan. The legal standard for FDA premarket review of a new tobacco product includes consideration of whether the product would be appropriate for the protection of the public health. We must factor in whether these products get kids addicted to nicotine. It’s that simple. And we are taking aggressive actions today to address this. This may create some obstacles for some adults who also enjoy e-cigs. These are the hard tradeoffs that we’re grappling with. But the youth risk is paramount. It’s now clear to me, that in closing the on-ramp to kids, we’re going to have to narrow the off-ramp for adults who want to migrate off combustible tobacco and onto e-cigs. This isn’t our choice alone. I’ve been warning the e-cigarette industry for more than a year that they needed to do much more to stem the youth trends. In my view, they treated these issues like a public relations challenge rather than seriously considering their legal obligations, the public health mandate, and the existential threat to these products. And the risks mounted. Well, I’m here to tell them that this prior approach is over. The FDA is closely watching the trends in youth use. And if, as we expect, preliminary data that’s in our possession and will be finalized and released in the coming months confirm our present observations that the youth use of e-cigs is rising very sharply; we’ll swiftly change course. In the meantime, the FDA is announcing an escalating series of actions to forcefully address youth use trends. It starts with the steps that we’re taking today, with the announcement of the largest coordinated tobacco compliance effort in FDA’s history. In addition, as I noted, we’re seriously reconsidering our compliance dates for the submission of product applications when it is apparent that there’s widespread youth use of the product. We’re especially focused on the flavored e-cigarettes. And we’re seriously considering a policy change that would lead to the immediate removal of these flavored products from the market. Today, we sent letters to five e-cigarette manufacturers whose products were sold to kids during the enforcement blitz and that, collectively, represent more than 97 percent of the current market for e-cigs — JUUL, Vuse, MarkTen, blu e-cigs, and Logic. These brands will be the initial focus of our attention when it comes to protecting kids. They’re now on notice by the FDA of how their products are being used by youth at disturbing rates. Given the magnitude of the problem, we’re requesting that the manufacturers of these brands and products come back to the FDA in 60 days with robust plans on how they’ll convincingly address the widespread use of their products by minors, or we’ll revisit the FDA’s exercise of enforcement discretion for products currently on the market. Let me be clear. This may require these brands to revise their sales and marketing practices, including online sales; to stop distributing their products to retailers who sell to kids; and to remove some or all of their flavored e-cig products from the market until they receive premarket authorization and otherwise meet applicable requirements. In the meantime, we’ll be investigating their marketing and sales practices, including with boots on the ground inspections. The FDA is going to continue to work to find out why so many kids are using and abusing these products. And we’re not going to stop there. We’re also re-examining the enforcement discretion we currently exercise for other e-cig products currently on the market without authorization. Today’s letters target the five dominant e-cig manufacturers, including those whose products were purchased by kids in our enforcement blitz. But the policy reconsiderations apply to the entire category. As we do this, we’re considering how the different products are being used by kids. The biggest youth use seems to be among cartridge-based e-cigarettes, and not the open-tank vaping products. So, we’re exploring policy options that could let us adjust the policy steps we take to account for different product use patterns between kids and adults. Our focus is on the products that are being misused by minors. We’re also going to permanently step up our enforcement actions with a sustained campaign to monitor, penalize and prevent e-cig sales to minors in convenience stores and other retail sites. It’s clear there’s need for strong federal enforcement of youth access restrictions. We’ll continue to hold retailers accountable by vigorously enforcing the law with the help of our state partners. The e-cig manufacturers ought to follow suit. They should also ensure that their online sales are not part of the problem. Although today’s action included warning letters for online sales, following up on our retail blitz, we’re taking a hard look at the manufacturer’s own internet storefronts and distribution practices. We’ll look at whether internet sites are being used to make straw purchases with the intent for redistribution to minors. If young adults go online and buy 100 units of a product to sell to teens, that activity ought to be easy for a product manufacturer to identify, and FDA will consider what steps we can take in these circumstances. Let me be clear: Everything is on the table. This includes the resources of our civil and criminal enforcement tools. If the companies don’t know, or if they don’t want to know, that straw purchases are occurring, we’ll now be helping to identify it for them. If violative activities are found, the FDA has both civil and criminal remedies at its disposal. We are also investigating whether makers of certain e-cig products may be subject to enforcement for marketing new products that don’t have pre-market authorization and were introduced after the FDA’s compliance date. And next week, we’re also announcing a national campaign to warn teenagers of the dangers of nicotine and e-cigarette use. This public campaign will bring these public health messages to online sites that we know teenagers access, and even to high school bathrooms. I challenge e-cig manufacturers to take equally bold action to reform their own practices. There’s some historical advertising that I’ve seen, especially on social media, that gives me pause as to how earnest some of these companies were in making sure that kids didn’t use their products. As I noted earlier, we’ll also be taking steps beyond compliance and enforcement. We plan to update our recommendations that lay out the Pre-Market Tobacco Product application pathway and the evidence we expect to see when manufacturers file those applications. We believe there’s no excuse for manufacturers not to file applications with the FDA because the agency hasn’t told them what they are expected to do. If any manufacturer wants to get direct, precise guidance on a specific product application, just call us. Request a meeting. Our door is open. And our policy is to grant pre-submission meetings to help manufacturers understand our expectations. The staff of our Center for Tobacco Products is also working on an overall policy roadmap to address these trends, while remaining true to the goals of our comprehensive plan announced last summer, and to the public health purpose that animates our work every day. They’ll be presenting to me a strengthened approach, building on our Youth Tobacco Prevention Plan, to address the rising use of e-cigs by minors. I’ll communicate the additional decisions that we make together as an agency in a timely fashion. The steps I’m announcing today are the initial elements of these new efforts that we’re committing to right away. I believe there’s an epidemic of youth use. We have good reason to draw this conclusion based on the trends and data that we’ve seen, some of which is still preliminary and will be finalized in the coming months and presented publicly. But our actions today are firmly rooted in what we’ve learned. There’s no mistaking the risks. At the FDA, we still believe that new innovations that don’t use combustion, like the electronic cigarettes, offer an important opportunity for adults to transition off combustible tobacco. I still believe in this opportunity. I still believe in the concept of modified risk products. I still believe that tobacco products exist on a continuum of risk, and that there are opportunities to move adult smokers down that ladder of harm. The leadership of the FDA’s tobacco center still firmly believes in this concept. And we’re all committed to helping reduce the overall burden of risk to our nation. We’re committed to the purpose of harm reduction. We’re committed to saving lives. And we’re committed to changing the trajectory of death and disease from tobacco. We started to confront these trends right out of the gate with the comprehensive tobacco policy that we announced last summer. We ramped up these efforts with the announcement of our Youth Tobacco Prevention Plan last spring. And today, we’re taking a new turn in our efforts as youth trends worsen. We’ll bend that trajectory on this growing youth addiction. We must succeed. But we’re not the only party to this problem. Industry must step up to this challenge. The companies selling the brands that resulted in the most illegal sales in our enforcement blitz have 60 days to respond with forceful plans of their own or face regulatory consequences. They say they’ve changed from the days of Joe Camel. But look at what’s happening right now, on our watch and on their watch. They must demonstrate that they’re truly committed to keeping these new products out of the hands of kids and they must find a way to reverse this trend. I believe in the power of American ingenuity to solve a lot of problems, including this one. I’m deeply disturbed by the trends I’ve seen. I’m disturbed by an epidemic of nicotine use among teenagers. So, we’re at a crossroads today. It’s one where the opportunities from new innovations will be responsibly seized on right now, or perhaps lost forever. The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products. *This article was not written by Maxed Out Vape Written by the FDA 9/11/2018 https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-new-steps-address-epidemic-youth-e-cigarette-use

Medical Study: Smokers Switching To E-Cigarettes Unlikely To Go Back

Smokers who successfully quit using e-cigarettes are far less likely to relapse and pick up tobacco, according to a new study. Published in the British Medical Journal (BMJ), the study examined vapers– smokers and those who do both for a period of two years and wanted to see how effective e-cigarettes were in keeping people off cigarettes. “Of the e-cigarette users, 61.1 percent remained abstinent from tobacco (while 23.1 percent and 26.0 percent of tobacco-only smokers and dual users achieved tobacco abstinence),” the study said. “The rate (18.8 percent) of stopping use of either product (tobacco and/or e-cigarettes) was not higher for e-cigarette users compared with tobacco smokers or dual users.” (RELATED: Study Finds E-Cigarettes Raise Chances Of Quitting, ‘Can Save Lives’) The study concludes that using e-cigarettes alone may prevent smokers from drifting back to cigarettes. Writing to The Daily Caller News Foundation via email, Dr. Michael Siegel at the Boston University School of Public Health explained the study’s implications. “This study is useful for limited purposes,” said Siegel. “It does not provide information on the magnitude of the effectiveness of e-cigarettes for smoking cessation because it does not compare smokers who are randomized to receive e-cigarettes vs. smokers who are randomized to an alternative cessation approach (or to usual care). (RELATED: Game Changer: World Leading Medical Group Backs E-Cigarettes) “What it does demonstrate is that the rate of recidivism back to cigarette smoking is relatively low among vapers. In other words, if a person is successful in quitting smoking using e-cigarettes, there is a very good chance that he or she will be able to maintain their status as an ex-smoker. Moreover, the chances of a vaper being a smoker two years later are much lower than the chances of a smoker continuing to smoke two years later.” The big public health takeaway for Siegel is that if a smoker successfully switches from smoking to vaping, there is a very strong chance they will remain an ex-smoker. *This article was not written by Maxed Out Vape Written by Guy Bentley 6/7/2016 http://dailycaller.com/2016/06/07/medical-study-smokers-switching-to-e-cigarettes-unlikely-to-go-back/#ixzz4BCf2iQpI  

Propylene Glycol in eCigarettes Might Keep Us Healthy, Says Researchers

According to the Centers for Disease Control, during 2000-2004, "An estimated 443,000 persons in the United States died prematurely each year from smoking or exposure to secondhand smoke. During 2001-2004, the average annual smoking-attributable health-care expenditures nationwide were approximately $96 billion. When combined with productivity losses of $97 billion, the total economic burden of smoking is approximately $193 billion per year." Comparing the health risks of tobacco smoking to the Swine Flu brings out some interesting and thought provoking statistics. According to President Obama's Council of Advisors on Science and Technology on H1N1, "A plausible scenario is that the epidemic could cause between 30,000 and 90,000 deaths in the United States." That puts the comparison of real deaths of 443,000 smokers to a "war games guess" of 30,000 to 90,000 for the H1N1 influenza for which the government recently declared a Health Emergency. That declaration and the shortage of the H1N1 vaccine has caused a panic in the U.S. No study or statistic has been offered that points to the Swine Flu as being more deadly than tobacco cigarettes in causing death, yet a disproportional effort in preventative measures are currently being channeled to defend against a lower risk health issue. Toxic tobacco smoke contains many additional chemicals, including carbon monoxide and tar which is a sticky substance that accumulates in the lungs, causing lung cancer and respiratory distress. Tobacco is the leading cause of preventable death in the world and is responsible for more than 5 million deaths each year. What the flu vaccine is to H1N1 as a preventative, the electronic cigarette may be for the tobacco smoker. An electronic cigarette is a futuristic advancement in science that makes it look, feel, and taste like a tobacco cigarette, as the user duplicates the mechanical motions. It expels an almost odorless water vapor that looks like smoke, but isn't. The e cigarettes are battery-powered with a cartridge that typically contains nicotine in various levels (or none), propylene glycol and tobacco flavoring. In their October briefing, Action on Smoking and Health (ASH) in the United Kingdom released a favorable position on electronic cigarettes. Propylene glycol, the primary ingredient in the electronic cigarette cartridge, may be a powerful deterrent against pneumonia, influenza, and other respiratory diseases when vaporized and inhaled according to a study by Dr. Oswald Hope Robertson. Decades before the e cigarette was invented, a study was conducted by Dr. Robertson of the University of Chicago's Billings Hospital in 1942 on inhalation of vaporized propylene glycol in laboratory mice. A more in-depth article was printed in the 1942 issue of TIME Magazine http://www.time.com/time/magazine/article/0,9171,932876,00.html for November 16th. "Dr. Robertson placed groups of mice in a chamber and sprayed its air first with propylene glycol, then with influenza virus. All the mice lived. Then he sprayed the chamber with virus alone. All the mice died." The researchers also found that "the propylene glycol itself was a potent germicide. One part of glycol in 2,000,000 parts of air would--within a few seconds--kill concentrations of air-suspended pneumococci, streptococci and other bacteria numbering millions to the cubic foot." Clinical trials on electronic cigarettes containing propylene glycol were carried out in New Zealand by Dr. Murray Laugeson of Health New Zealand and can be found on the website of SS Choice LLC at http://www.eCigarettesChoice.com under the tab "Media Coverage." Far from posing a threat to our health, the propylene glycol in e cigarettes might just keep us healthy. Further studies should be done on the effects of propylene glycol to determine if it can be used successfully as a virus prevention tool. Wouldn't it be wonderful if the best flu preventative was right under our noses all this time? *This article was not written by Maxed Out Vape Source Noted: SS Choice, LLC http://www.news-medical.net/news/20091104/Propylene-glycol-in-e-cigarettes-might-keep-us-healthy-says-researchers.aspx

Six Vaping Trends to Watch in 2016

Written by Tim Klerekoper, Ph.D. January 26, 2016 *This article was not written by Maxed Out Vape With all the industry hype and changing trends, it might be easy to lose track of the most important factor driving the vaping industry, which is the goal to produce an effective alternative to tobacco cigarettes. It is important to never lose sight of that objective. The vaping industry climate arguably can be described by the “pendulum” theory. At first the industry was all about not smoking. Over time, a small percentage of the industry headed left, and another small percentage headed right. On the one hand you have people trying to ban e -cigs, and on the other you have increasingly high wattage vaping with more and more powerful systems. Mind you, let’s not knock people who “chase clouds,” and we should also appreciate people who believe that reasonable regulation of the industry is important (emphasis on the word “reasonable”). It is crucial to remember, however, that the vast majority of the industry is still stuck smack- dab in the middle. Given this industry divide, there are six key industry trends will likely prevail in 2016. #1 Quality or “The latest”? When we shop for a car, most people compare manufacturers. They look for cars with a good track record and great ratings. They should look for the same thing in an electronic cigarette. Where was the mod made? What materials did they use? What kind of testing does the manufacturer implement? Of concern is what might be seen as a continuing trend of e cig manufacturers using their customers as guinea pigs. When a company can go from an initial product concept to putting product out to the market in just weeks, we probably should be suspicious. Companies that put out high quality products usually take longer to get that product to market, but in the long run it’s usually worth it. Another concern is the existence of a new technology bias—the idea that new is inherently better. A key example of this in 2015 was the movement toward temperature control. While the companies that introduced it can be applauded for introducing a great concept, there should still be critique about the way the temperature of a coil is determined (or not) as the case might be. Algorithms have their limits, and if you advertise you can “control” or “limit” the temperature of a mod, you’d darn well better be certain your measurement is accurate. Perhaps it should have been billed as “temperature guessing.” We should take a close look at products that are introduced before they are perfected, but having said that, we should look forward to the continuing development of that temperature- based technology. #2 Flavor and vapor are better than ever! In the early days of vaping it was all about replacing the amount of smoke a cigarette produced. The vast majority of vapers still want just enough vapor to replace a bad habit, yet we see a trend of those people walking out of vape stores with high wattage mods and tanks that go way beyond their needs. It makes as much sense as selling a Formula 1 racing car to someone looking for a four -door sedan! We do need to give a great deal of credit to coil builders for upping the ante when it comes to vapor and flavor. There was a period when a hand- built coil on an RDA could produce considerably better flavor and vapor than tanks, which is most likely one of the reasons tanks have trended towards better flavor and vapor is because the coilers set the bar higher for the industry as a whole. #3 Battery life is getting better, but at what cost? Cigalike products frustrate users for two reasons—first, is the tiny amount of e- liquid they hold and second is running out of battery power just when it is most inconvenient. On the other hand, there are box mods on the market now that weigh more than a quarter horse. Fancier coils and sub- Ohm tanks are requiring higher and higher wattage and more and more battery power, but at what risk? Use a battery incorrectly and you could pay a significant price. What does the manufacturer of the battery suggest? The answer might surprise you! #4 Safety should be non-negotiable. Nobody should be willing to take a risk that his or her e- cig’s battery will vent, so it is logical that consumers should not only purchase mods that have safety features on- board, but also mods that have been thoroughly factory -tested. Reverse battery protection and thermal monitoring with multiple safety backup systems shouldn’t be an option. Is your mod electronically and structurally safe? Another positive trend in the industry is the rising quality of e- liquid. In the early days you could order e- liquid from a nationally known company and get a plastic bottle with a handwritten label that gave virtually no information about the quality of the ingredients inside. Now, a great many e-liquids are produced with extensive labeling, in a clean- room lab under sterile conditions, and packaged with child -resistant caps. Many companies are also testing for potentially hazardous chemicals. The vaping industry should be proud of the fact that without having been regulated, e -liquid manufacturing is definitely trending toward safety. #5 Durability and longevity need some improvement. The quality of e- cigs in this industry varies widely. Repair rates can vary from one half of one percent to more than 40 percent! Consumers should reasonably be able to expect a lot better quality than that. Can your e -cig even be repaired? A lot of companies don’t even offer that option! Don’t even ask what happens when a mod is inadvertently dropped. How often are mods drop tested? Our industry has collectors and those who are into purchasing whatever the latest technology is, but most vapers simply want an effective, reliable system that lasts. A large segment of industry products won’t last more than six months. A good quality model might cost you a bit more at the beginning, but will save you a lot over the time you use it. It will be important to this industry to see a trend toward higher quality, more reliable models. #6 Political trends are challenging. Political trends in the vaping industry have been challenging at best. Many agencies (local, state, and national) have been critical of the industry, citing a combination of consumer claims, safety incidents, and medical studies. Given the relative novelty of the vaping industry (compared to tobacco), studies are still relatively limited in scope. An important step for manufacturers moving forward will be to look objectively at these critiques and assess where their products lie in relation. This way, any feature- specific safety and health concerns can be identified and changes can be made as needed. The upcoming year will likely see more of these efforts, along with an industrywide effort to better define standards for manufacturing and practice. Overall, vaping industry trends are headed in the right direction, but there is a lot of work to do. Each individual vaper needs to realize that they are personally responsible for helping set industry trends. As a unified group, they can achieve vaping’s most important goal, while enjoying themselves in the process.

Electronic Cigarettes Vapor Has NO Toxic Effect

In a recent study, scientists have found electronic cigarette vapor has NO toxic effect on the cells found in human lungs. Fresh research, funded by British American Tobacco (BAT), suggested inhaling nicotine vapor could be as safe as breathing air. To perform these experiments, the tobacco giant teamed up with the MatTek Corporation, maker of human cell models used in “in vitro” laboratory experiments. Scientists then used a “smoking robot” to expose these lung cell replicas to tobacco smoke, two different brands of e-cig vapor, and plain old air. After being exposed to old-fashioned smoke for six (6) hours, the cells died. However, after subjecting the cells to an “aggressive and continuous” dose of e-cig vapor, researchers claimed the damage to the airway tissue was “similar to that of air”. BAT spokesperson, Dr Marina Murphy, stated “by employing a combination of a smoking robot and a lab-based test using respiratory tissue, it was possible to demonstrate…. the e-cigarette aerosols used in this study have no [toxic] effect on human airway tissue.” There are plans to tests a wider variety of e-cigs, to prove its results. “Currently there are no standards concerning the ‘in vitro’ testing of electronic cigarette aerosols,” said Marina Trani, ‎Group Head Scientific Product Stewardship at British American Tobacco. “Our protocol could prove very useful in helping the process by which these guidelines might progress.” The debate about e-cigarette safety has been raging for several years. Study after study have highlighted health risks, although most experts agree vaping is much safer than smoking cigarettes. Dr Michael Siegel, professor in the Department of Community Health Sciences at Boston University’s School of Public Health, welcomed the latest study as evidence of the safety of electronic cigarettes; stating “Despite the limitations of the research, it adds additional evidence to support the contention that vaping is a lot safer than smoking.” He called on public health bodies and anti-tobacco groups alike to encourage smokers to swap to vaping; a step which would “transform the nicotine market and achieve a huge public health victory.” going on to proclaim, “Such a phenomenon would result in the greatest public health miracle of our lifetimes.” However, the health expert warned overheating liquid nicotine could produce dangerous toxins. Personally, overheating e-juice taste horrible and should be avoided for that reason alone. Vaping advocates claimed the previously research results, which found e-cigs vapor held dangerous chemicals, were false due to the nicotine liquid being exposed to high temperatures. VokeEarlier this year, British American Tobacco announced the release of a device called Voke, not currently available on the market, which is licensed as a medicine and produces no heat, working more like an asthma inhaler than an electronic cigarette. Tom Pruen, Chief Scientific Officer of the Electronic Cigarette Industry Trade Association, stated he was satisfied the latest research was accurate. “While I’m sure that for many the source of the research will be a problem, of recent years the science conducted by the tobacco industry has been of very good quality, and despite the historic issues I wouldn’t view it with any greater skepticism than research conducted elsewhere,” he said. He went on to add, “the results are not unexpected. Not only are the components of an e-cig aerosol expected to be of low toxicity, based on a large number of analytical studies, but this research broadly agrees with a previous study.” *This article was not written by Maxed Out Vape Source: http://vapeform.com/vaping-news/new-study-electronic-cigarettes-vapor-has-no-toxic-effect/