November 19, 2019
LA Times reporter Emily Baumgaertner dug through documents that the FDA obtained from Juul as part of its investigation of the company to write an excellent article, "Juul wanted to revolutionize vaping. It took a page from Big Tobacco’s chemical formulas." She shows how James Monsees and Adam Bowen, the two guys who came up with Juul, used the UCSF Truth Tobacco Industry Documents Library, RJR patents and other materials to come up with the idea of using nicotine salts to develop their highly addictive product.
Lauren Lempert and I put in a FOIA for the material that the FDA obtained from Juul. While the FDA only released a tiny fraction of the material they have -- citing the need to protect Juul's trade secrets for witholding the rest -- Baumgaertner found a lot of important material in what was released.
November 17, 2019
Christopher Russell and colleagues recently published “Factors associated with past 30-date abstinence from cigarette smoking in adult established smokers who used a JUUL vaporizer for 6 months” in the Harm Reduction Journal. Their primary conclusion was “More frequent use of a JUUL vaporizer and primary use of JUUL pods in characterizing flavors, particularly mint and mango, appeared to be important to smokers' chances of quitting.” They added that, “The impact of suspending retail sales of flavored JUUL pods on adult smokers' likelihood of quitting should be closely assessed.”
In other words, cities, states and even the FDA should keep mint and mango pods – which are popular with kids – on the market to help adults quit smoking.
The paper is based on a large sample of 15,456 adult established smokers, which sounds pretty impressive until you look at how the sample was generated. It came from 37,536 people who bought Juul online from Juul directly or responded to one of 500,000 flyers included in Juul packs inviting people to participate. Judged against this universe of 514,456 possible respondents, the investigators only had a 2.9% response rate, well below what is considered reliable in survey research.
November 16, 2019
All the evidence from studies of e-cigarettes and heated tobacco products is pointing to the conclusion that the FDA, our friends in England, and others are way too focused on combustible tobacco products. Inhaling an aerosol of ultrafine particles of various carriers, flavors, and other chemicals is being linked to a wide range of adverse effects.
That case continued to expand with release of the new study "Impairment of Endothelial Function by Aerosol From Marijuana Leaf Vaporizers," which will be presented by Jiangtao Liu, Pooneh Nabavizadeh,Poonam Rao, Ronak Derakhshandeh and Matthew L Springer at the American Heart Association Annual Scientific Sessions this week.
November 15, 2019
The paper “Short-term e-cigarette vapour exposure causes vascular oxidative stress and dysfunction: evidence for a close connection to brain damage and a key role of the phagocytic NADPH oxidase (NOX-2)” recently published by Marin Kuntic and colleagues in the European Heart Journal is a real-tour de force that includes human, mouse, and isolated cell studies to not only show that e-cigarette use has adverse effects on blood vessels (in several places throughout the body), but defines the cellular and molecular pathways responsible for these effects.
Consistent with earlier studies, they founds that e-cigarette smoking immediately compromised the ability of arteries to dilate (expand) in response to increases in the need for blood flow (called flow-mediated dilation). Significantly, they found this effect in smokers, which is consistent with our (paper 1, paper 2) and others’ epidemiological findings that e-cigarettes pose an independent risk of having had a heart attack (myocardial infarction) in smokers.
November 12, 2019
Despite the continuing happy talk coming out of our colleagues in England that the epidemic of serious lung illness in e-cigarette users is a US-phenomenon, BMJ’s Archives of Disease in Childhood just published a case report, “Life-threatening hypersensitivity pneumonitis secondary to e-cigarettes.” The youth used nicotine e-cigarettes.
Here is the abstract: