AVA Synopsis:
The authors examined data from the Centers for Disease Control and Prevention’s (CDC) cases of vaping-related lung injury, the public advice from both the CDC and the U.S. Food and Drug Administration (FDA), media reporting of the outbreak, “and proposed regulatory responses by governments in the United States, Australia and the United Kingdom.”
The authors found that the CDC “initially suggested that the cause of the outbreak was nicotine vaping,” though case studies were indicating that the majority of vaping-related lung injuries were among persons that had used vapor products containing tetrahydrocannabinol (THC) and vitamin E acetate. The CDC, FDA and news media “were slow to report the evidence on the role of cannabis vaping.”
The authors conclude that public health advice and media reporting on vaping-related lung injuries “contributed to regulatory over-reactions to nicotine vaping by the public health community.”
Implications:
Many policymakers used the outbreaks of vaping-related lung injuries to further regulate and/or ban e-cigarettes and vapor products. It is important that in future policies, regulations reflect the evidence that found a majority of vaping-related lung injuries were caused by illicit products.
Abstract:
Aim: To describe an outbreak of lung injuries in 2019 among people who vaped in the United States (type of injuries, people afflicted, substances vaped and cause of the injuries) and to analyse critically the regulatory responses of public health authorities and the media reporting of the outbreak.
Methods: Case studies of the reporting of the e-cigarette or vaping product use associated lung injury (EVALI) outbreak. We examined data on the number of cases of lung injury provided by the US Centers for Disease Control (CDC), public advice on the causes of the outbreak provided by the CDC and the Food and Drug Administration (FDA), major media reports of the outbreak and proposed regulatory responses by governments in the United States, Australia and the United Kingdom.
Results: The CDC initially suggested that the cause of the outbreak was nicotine vaping because the outbreak followed a large increase in nicotine vaping among US adolescents. Case-control studies revealed that the majority of cases had vaped illicit cannabis oils that were contaminated by vitamin E acetate. The CDC’s public advice and the media were slow to report the evidence on the role of cannabis vaping. Popular government regulatory proposals-bans on sales of nicotine flavours and vaporizers-were based on the assumption that nicotine vaping was the cause of the outbreak.
Conclusions: Media reporting in the United States, Australia and the United Kingdom of the US Centers for Disease Control’s analysis of the causes of the e-cigarette or vaping product use associated lung injury outbreak contributed to regulatory over-reactions to nicotine vaping by the public health community.
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