Europes missing vaping sickness

Europe does not appear to be experiencing an outbreak of the “vaping sickness” gripping the U.S.

Its not clear anyone would know if it was.

U.S. President Donald Trump on Wednesday moved to finalize a ban on flavored e-cigarettes in light of the countrys outbreak of a vaping-related illness thats made 450 people sick and resulted in at least six deaths. With the U.S. Food and Drug Administration urging people to avoid buying unregulated vape products, other U.S. experts say people should avoid all e-cigarettes until the cause is clear.

In European countries like the U.K. and France, which have voluntary reporting systems, theres not much evidence of this problem, and experts cite tighter e-cigarette regulations in Europe than the U.S.

“We have not seen anything like what weve seen in the U.S. recently in Europe, to my knowledge as a scientist, and Im pretty aware of the field,” said Constantine Vardavas, the European Respiratory Societys scientific relations director with the EU.

“Youre terrifying people who are benefiting from vaping by not smoking.” — Clive Bates, former chief of the U.K. charity Action on Smoking and Health

But while several EU and national agencies said they are monitoring the U.S. situation, they werent always able to say whos keeping track on this side of the Atlantic. An EU-wide reporting system is still in the works, and a broad analysis of e-cigarette safety is only due in the fall of 2020.

Some EU experts say theres no reason to think this side of the Atlantic will be immune.

Though the cases are currently limited to the U.S., the Portuguese Society of Pulmonology said in a statement Wednesday that “they are likely to arise in other countries, including Portugal,” given the widespread availability of e-cigarettes.

“The use of electronic cigarettes is dangerous and not recommended,” the society said.

The lesser evil

This debate has extra resonance in the U.K., where the government has embraced e-cigarettes as a way to wean people off tobacco.

There, officials say the worst thing people could do is go back to regular cigarettes out of fears that vapes could land them in the hospital with a major lung malfunction.

“Youre terrifying people who are benefiting from vaping by not smoking,” said Clive Bates, a former chief of the U.K. charity Action on Smoking and Health (ASH) and a strong defender of e-cigarettes as a smoking cessation tool.

Bates argued that authorities should be delivering more targeted warnings about unregulated products. Instead, he said the U.S. medical establishment is creating one of the “darkest episodes in American public health … They have lost all their moorings with evidence and good practice.”

The U.K. has the worlds third-highest uptake of e-cigarettes, and government health officials promote vapes as a way to wean people off more harmful tobacco. Over the past year, according to the countrys Medicines and Healthcare products Regulatory Agency (MHRA), only 12 incidents of health problems with nicotine-containing e-cigarettes have been reported to the regulators voluntary system.

Among those, seven involved respiratory problems, and none of the cases were considered serious or required hospitalization. (Even in these cases, its not known if the e-cigarette was the cause of the reported problems.)

But there are some major caveats that leave room for concern. The U.K. has seen at least one case that has key similarities with the U.S. “vaping sickness,” which is essentially lipoid pneumonia — the accumulation of fat particles in the lungs. Doctors suspected the patients vaping liquid was to blame.

The case, discussed in the BMJ, does not appear to have been logged with the U.K. regulator. A separate system to report problems with illicit drugs is still in a pilot phase.

EU regulations also put the burden on manufacturers and importers to look out for health problems and address them.

Meanwhile, the cases in the U.S. increasingly appear to involve vape liquid containing THC, which is still illegal in the majority of EU countries (as well as most U.S. states). That may mean reporting systems arent taking all the products people actually use into account. The MHRAs system accounts only for nicotine-based vapes.

Martin Dockrell, head of tobacco control at Public Health England, was quick to offer reassurances about the safety of legal vapes. “What little we know of recent reports from the U.S. is that the devices used appear to be linked to home brews of illicit drugs and not legitimate vaping products,” he said. “Unlike the U.K., which has strict regulation … on e-cigarette safety, the U.S. has no regulation.”

Only in America?

U.S. regulators inspect some vape manufacturing sites and bar some ingredients from e-cigarette liquids. But that oversight is considerably less comprehensive than the EUs Tobacco Products Directive, whRead More – Source

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