Tobacco Center Faculty Blog

September 15, 2019

Stanton A. Glantz, PhD

The search for what is causing all the severe pulmonary disease associated with e-cigarette use has focused on possible “contaminants” and the fact that many, but not all, the people who got sick used THC e-cigs, often as well as nicotine e-cigs.

But, based on the strong mouse study showing propylene glycol/vegetable glycerin (PV/VG) damages surfactant in lung air sacs, creating lipid globules that are taken up by macrophages that seem the same as has been seen in e-cig users who develop serious lung disease, I wonder if it is PG/VG that is causing, or one of the main causes of these serious cases of lung disease.

In addition to being used in virtually all nicotine e-cigs, it is used in at least some THC e-cigs.

This doesn’t mean that there could not be other things going on, but PG/VG, which is not a “contaminant” deserves serious consideration.

September 14, 2019

Stanton A. Glantz, PhD

The American Medicine and Public Health Historians and the Organization of American Historians together with 35 medical historians and related academics has filed an amicus brief in the National Prescription Opiate Litigation in federal court in Ohio calling on the court to require public disclosure of the discovey documents prroduced in the case.  They argue that making the tobacco litigation documents publich has served the public interest and that the same thing should be done in the opioid litigation.

September 13, 2019

Stanton A. Glantz, PhD

The media has presented the anticipated FDA action on flavored e-cigarettes as a “ban” on flavors.  The FDA is not planning to issue a regulation (technically a product standard under Section 907 of the Tobacco Control Act) prohibiting the use of flavors.  Rather, it is planning to adjust and finalize the draft “compliance policy” it proposed in March 2019 by stopping to use its “enforcement discretion” to allow illegal e-cigarette products to remain on the market.

This is a good idea, at least in the short run, because, unlike a regulation, which could take years to finalize, the compliance policy will take effect 30 days after it is announced (unless the industry manages to block it in court).

To understand what this means, it is important to understand that after the August 2016 “deeming rule,” all e-cigarettes on the market became illegal because they were tobacco products under FDA jurisdiction that were being sold without a “marketing order” from the FDA, which is required to legally sell new tobacco products like e-cigarettes.

September 10, 2019

Stanton A. Glantz, PhD

The Washington Post just published my oped arguing that the most important thing to come out of tobacco litigation was the truth; attorneys general and others suing drug and fossil fuel companues need to follow the tobacco precident.  Read the oped here.

September 7, 2019

Stanton A. Glantz, PhD

As health officials struggle to understand the increasing number of serious lung disease, a new experimental study using mice may provide some clues about what is going on.

Matthew Madison and his colleagues published “Electronic cigarettes disrupt lung lipid homeostasis and innate immunity independent of nicotine” in Journal of Clinical Investigation.  They exposed mice to e-cigarette aerosol without and with nicotine and found that the aerosol altered lipid (fat) balance in the lungs in ways that depressed the ability of the lung macrophages to fight infections and disrupted normal production of surfactants, chemicals in lungs that help keep the airsacs from collapsing.   This effect did not depend on the nicotine, but was related to the propylene glycol and vegetable glycerin that are the primary carriers in e-cigarettes.