Monthly Archives: June 2022

With the FDA ordering Juul to stop selling their e-cigarette devices, UNC School of Medicine researchers led by Ilona Jaspers, PhD, published the first study to compare the respiratory immune health effects of different types of devices.

CHAPEL HILL, NC Not all electronic cigarette devices are created equal. Some fourth-generation models such as Juul devices are associated with unique changes in markers of immune responses inside our airways, according to a new peer-reviewed paper from UNC School of Medicine researchers led by toxicologist Ilona Jaspers, PhD, director of the UNC Center for Environmental Medicine, Asthma, and Lung Biology and director of the UNC Curriculum in Toxicology and Environmental Medicine.

Lead author Elise Hickman, PhD, a recent graduate from Jaspers lab, and colleagues, who published their research in the American Journal of Respiratory and Critical Care Medicine, found that users of fourth-generation nicotine-salt-containing devices display a unique mix of cellular biomarkers indicative of immune suppression.

Our work demonstrates the importance of considering device type in future clinical, epidemiological, and mechanistic studies on the health effects of e-cigarettes, said Jaspers, professor of pediatrics and microbiology and immunology. We also think this research can help regulators determine which products cause the most severe types of biological changes in airway cells important for maintaining proper health.

Electronic cigarettes have increased in popularity over the past decade. Some people began using them as a means to quit smoking, thinking vaping was a safer alternative, both in the short-term and long-term. Also, because electronic cigarettes lack tar, consumers assumed vaping decreased their risk of cancer down the road.

Its impossible to know if vaping decreases cancer risk or many other long-term conditions, Jaspers said. It took 60 years of research to show that smoking causes cancer. E-cigarettes have been around for about 15 years. Still, the research from our lab and many others has shown many of the same acute biological effects in the airways that we have documented in smokers, she said. And weve seen some changes to cells and immune defenses in people who vape that, frankly, weve never seen before, which is very concerning.

Most concerning to researchers, doctors, and public health officials is the fact that teenagers who would not have otherwise tried cigarettes began using e-cigarettes, which contain nicotine a drug with its own health implications even beyond addiction and thousands of chemicals, many of which the FDA approved for eating but not inhaling.

Several studies have documented that inhaling chemical-laden nicotine aerosols suppresses the immune responses in the respiratory tracts of smokers and e-cigarette users. Some studies, including some at UNC, have detailed how different chemicals in various e-cigarettes, including chemicals that make up thousands of different flavors, have adverse effects on airway cells. The Jaspers lab, which has been at the forefront of such research, set out to study the effects of different varieties of e-cigarette devices. For this study, her team collected central airway (sputum) samples from non-smokers, smokers, and users of both third-generation and fourth-generation e-cigarette devices.

Third-generation devices include vape pens and box mods. Fourth generation include nicotine-salt-containing e-cigarettes, such as Juul products, and disposable e-cigarettes, which have become increasingly popular following restrictions on the sale of Juul products.

Fourth-generation e-cigarette users had significantly more bronchial epithelial cells in their sputum, and this suggests airway injury because normally, bronchial epithelial cells make up an intact barrier in the airways and are not found in sputum samples. Levels of two proteins, sICAM1 and sVCAM1, were significantly lower in fourth-generation e-cigarette users compared to all other groups. These proteins are important in fighting infections and other disease.

Also, proteins CRP, IFN-g, MCP-1, uteroglobin, MMP-2, and VEGF were significantly lower in fourth versus third generation e-cigarette users, and all of these proteins are important for overall immune defense. So, the more diminished these proteins are, the more suppressed our immune systems are. Another key finding of the study was that, when examining the mixture of immune markers overall rather than one by one, fourth generation e-cigarette users had the most distinguishable changes out of all of the groups, indicating a shift away from immune homeostasis, said Hickman.

This research does not reveal evidence that e-cigarettes cause cancer, emphysema, COPD, or other long-term diseases associated with long-term cigarette smoking. But researchers think that altering immune responses in the respiratory tract over the course of many years, especially for teens, could play a major role in the development of long-term health conditions and in susceptibility to inhaled pathogens.

The National Institutes of Health funded this research.

Elise Hickman, who earned an Impact Award from the UNC Graduate School, is the first author of the paper, and Ilona Jaspers is the senior author. Other authors are Alexis Payton, Parker Duffney, Heather Wells, Agathe S. Ceppe, Stephanie Brocke, Aleah Bailey, Meghan E. Rebuli, Carole Robinette, Brian Ring, Julia E. Rager, and Neil E. Alexis.

Media contact: Mark Derewicz, 919-923-0959

Excerpt from:

Fourth-generation Vaping Devices Increase Risk to Immune Cells | Newsroom - UNC Health and UNC School of Medicine

On June 23, 2022, the U.S. Food and Drug Administration announced that all Juul products must be removed from U.S. markets. This decision essentially broadened an existing ban on teen use of the companys nicotine e-cigarettes to include adults as well. The next day, Juul asked a federal appeals court to temporarily block the ban while Juul challenged the decision. The court agreed to the pause, and for now, Juul products are still for sale in the U.S.

Lynn Kozlowski of the University at Buffalo has been studying nicotine and cigarette addiction for decades. He explains how the recent fight over Juul products fits into the larger discussion of e-cigarettes, tobacco use and public health among adults and teens.

According to the FDA, the decision was a precautionary response due to a lack of sufficient evidence regarding the toxicological profile of the products to ensure protection of public health. The FDA also noted that it hadnt received any information suggesting Juul products were an immediate hazard.

In the announcement, FDA commissioner Robert M. Califf commented on the effects Juul products have had on youth vaping. And this decision comes at a time when some have hoped that a new ban on Juul products and other e-cigarettes for adults would help reduce vaping by teens.

Cigarettes kill at least 1-in-2 smokers prematurely and cut smokers lives short by an average of 10 years due to cancer, obstructive lung disease and cardiovascular disease.

There is not yet any long-term epidemiological data available on e-cigarettes. But U.S. and British assessments have concluded that while vaping is likely to be substantially less harmful than cigarettes, it is not risk-free. Potential harms include nicotine addiction as well as some cardiovascular risks, though these are estimated to be lower than risks from cigarettes.

I do not encourage that anyone vape if they do not need to. But if someone would otherwise smoke cigarettes, and vaping helps them stop smoking completely, e-cigarettes can be a useful tool for reducing the smoking and health problem. Quitting cigarettes is unequivocally good for your health. Research shows that if a person stops using cigarettes by age 40, they on average avoid 90% of the increased risk of death compared to if they continued smoking. If a person stops smoking cigarettes by age 30, their health risks are nearly the same as a person who never smoked.

The CDC says that there is limited evidence that vaping helps people quit smoking cigarettes. The FDA, in approving some e-cigarettes for sale, expresses the view that e-cigarettes can be a beneficial tool for smokers who significantly reduce their cigarette use or stop smoking by switching to e-cigarettes.

Recent studies have also shown that e-cigarettes are more effective than nicotine replacement medicines in helping people who want to quit smoking. The National Health Service in the United Kingdom includes vaping as an approved way to quit smoking.

Teen vaping is on a downward trend. Data from the CDC showed that in 2019, 27.5% of high school students reported vaping at least once in the previous month. That number fell to 19.6% in 2020 and to 11.3% in 2022. Just over a one-quarter of monthly users or about 3% of high school students in 2022 report vaping on a daily basis.

Some of these decreases were likely due to COVID-19, enforcement of restrictions on youth access and government anti-vaping campaigns.

Widespread publicity about a serious lung disease caused by vaping, called EVALI, very likely turned many away from vaping. This was despite the fact that research eventually showed the disease was mostly caused by black market cannabis vaping products.

Despite the encouraging drop in teen vaping, an important question to ask is whether vaping directly leads to later cigarette smoking.

Parents are justly concerned that vaping could be a gateway to smoking. But research doesnt seem to support a strong causal connection. While vaping surged nationally in recent years, smoking rates fell.

Using several years of U.S. data from the National Youth Tobacco Survey on almost 40,000 participants, researchers found that less than 1% of those who first used e-cigarettes went on the become established cigarette smokers. People who vaped first were also less likely to become smokers than those who had tried cigarettes or other tobacco products first.

Another large study of U.S. youth found that a history of e-cigarette use was associated with only modest or nonsignificant increases in cigarette smoking once the researchers controlled for general risk-taking behavior.

Even if vaping is not a big factor in causing teens to become smokers, teen use of vaping products is a concern despite a ban on the sales of e-cigarettes to people under 21 in 2019.

Completely banning a product that is useful for adult smokers who are looking to quit is not the only way to help reduce youth access. One proposal, for example, suggests moving the sales of all nicotine and tobacco products to stores that are only accessible to those 21 or older.

While products like Juul deserve study and regulation, it is important to keep in mind the proven deadliness and easy availability of cigarettes both to adults today and to the many teens who start smoking every year and will become adult smokers. Getting as many smokers as possible off tobacco cigarettes will save lives.

See the rest here:

The FDA and Juul are fighting over a vape ban, but the role of e-cigarettes in the world of tobacco abuse is not clear-cut - The Conversation

E-cigarettes contain nicotine and other chemicals that may damage the esophagus. They may also cause or worsen the symptoms of gastroesophageal reflux disease (GERD).

However, research into this area is still in the early stages. The potential adverse health effects of vaping warrant further investigation by scientists.

This article discusses vaping and the harmful contents of electronic cigarettes, known as e-cigarettes. It also explores GERD and how vaping can affect its symptoms.

Vaping is the word that some people use to describe using an e-cigarette. E-cigarettes produce an aerosol a suspension of small solid particles or liquid droplets in the air by heating a liquid containing nicotine and other chemicals. They come in many different shapes and sizes, resembling cigarettes, pens, USB sticks, or pipes.

E-cigarettes may contain several potentially harmful substances, including:

In 2018, approximately 8.1 million adults in the United States used e-cigarettes. The Centers for Disease Control and Prevention (CDC) advise that e-cigarettes have the potential to benefit some adults who currently smoke and wish to stop.

However, the organization warns that people who do not smoke should not start vaping. Furthermore, e-cigarettes are unsafe for the following groups of people:

GERD is a chronic medical condition associated with acid reflux. The American College of Gastroenterology notes that acid reflux can lead to GERD.

When someone has GERD, gastric acid and bile flow from their stomach into their esophagus. An esophageal sphincter a band of muscle that acts as a valve usually prevents the stomach contents from moving into the esophagus. However, certain foods, lifestyle habits, and health conditions can weaken this barrier, causing GERD.

Doctors will monitor and treat GERD because it may lead to esophageal cancer. They may prescribe medications such as H2 receptor antagonists, known as H2 blockers, and proton pump inhibitors (PPIs). Additionally, they may advise someone to make changes to their diet and lifestyle.

Research indicates that GERD prevalence is significantly higher among people who smoke than among those who do not. Quitting smoking can improve GERD, as well as health-related quality of life.

An older study involving about 50,000 individuals found that close to 20% of those who smoked hookah had symptoms of GERD at least once a week.

The researchers of the study explain that smoking cigarettes reduces the lower esophageal sphincter pressure and the salivary secretion of bicarbonates. These effects may cause gastroesophageal reflux episodes.

Additionally, the study indicates that the puff volume in hookah smoking is several times bigger than in cigarette smoking, which may increase GERD symptoms.

However, because vaping is a relatively new phenomenon, there is little research about its effects on GERD.

One example is a 2021 case study. The study found that an individual whose GERD was under control presented with inflammation of the esophagus, called esophagitis, associated with vaping.

The authors suggest that vaping may cause mucosal injury, oxidative stress, and DNA damage. In addition, they note that the inconsistent regulation of e-cigarettes can result in people inhaling unknown chemicals and toxins.

Finally, they stress the need for further investigation into the link between GERD and vaping.

The CDC explains that because e-cigarettes are fairly new, scientists are still learning about their long-term health effects. However, this is what they know so far:

In addition, the CDC notes that by February 2020, e-cigarette, or vaping, product use-associated lung injury (EVALI) had caused 2,807 deaths and hospital visits in the U.S.

The CDC adds that laboratory data show that vitamin E acetate, an additive in some tetrahydrocannabinol-containing e-cigarettes, is significantly related to the EVALI outbreak.

However, EVALI cases have declined due to more public awareness, fewer products containing vitamin E acetate, and law enforcement actions against illicit products.

The National Library of Medicine (NLM) explains that the severity of a persons symptoms will determine what treatments doctors recommend. However, the options may include:

In addition, the NLM advises that the following lifestyle modifications may help relieve the symptoms of GERD:

Lifestyle changes are the primary treatment for GERD.

Below are some of the most common questions about vaping and GERD.

Research indicates that nicotine may affect the function of the gastrointestinal system. Smoking cigarettes or vaping may cause digestive issues, such as heartburn or GERD.

Nicotine can potentially make GERD symptoms worse. Therefore, people with GERD may wish to consider avoiding e-cigarettes or quitting smoking.

Some evidence suggests that vaping may cause inflammation of the esophagus and affect the valve that prevents stomach acid from flowing into the esophagus.

Although vaping is relatively new and studies are limited, some research suggests that it may worsen GERD symptoms. Nicotine and other chemicals in e-cigarettes may cause inflammation and affect the function of the valve that prevents stomach acid from rising into the esophagus.

Although vaping may help some people quit cigarettes, pregnant people, adolescents, and those who do not already smoke should avoid e-cigarettes.

A person should speak with a doctor if they are experiencing symptoms of GERD.

See more here:

What is the relationship between vaping and GERD? - Medical News Today

Google has updated its rich results content guidelines to align better with the overall Google merchant guidelines thus disallowing rich results for products that are widely prohibited or regulated, or that can facilitate serious harm to self or others.

These include, but are not limited to, weapons, recreational drugs, tobacco & vaping products and gambling-related products.

New rich results guidelines. Google has updated the rich results product content guidelines to add this section:

Dont mark up content that promotes widely prohibited or regulated goods, services, or information that may facilitate serious and/or immediate or long term harm to self or others. This includes content related to firearms & weapons, recreational drugs, tobacco & vaping products and gambling-related products.

Application. Google said this policy applies to all forms of rich result markup, including star ratings, prices, or availability information and more. This can impact products with rich result structured data markup that are widely prohibited or regulated, or that can facilitate serious harm to self or others. This could include goods like fireworks, recreational drugs, and other products that can pose acute threats of physical harm, a Google spokesperson told Search Engine Land.

Effective immediately. Google told us this policy goes into affect today, at the time this story has published.

Why we care. If you sell any of these types of products, you will probably want to remove the structured data markup from those pages. If you do not remove the markup, either way, Google will not show rich results for these product categories.

We did ask Google if you will receive some sort of manual action within Google Search Console and Google said it will not issue manual actions, instead Google will simply just remove the rich results for these types of search results. So no manual action will be given but technically the removal of these rich results is the penalty one would receive for violating the rich results content guidelines.

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Google rich results guidelines now prohibits weapons, recreational drugs, tobacco & vaping products and gambling-related products - Search Engine...

Leafly editors and contributors choose products based on personal experience, consumer feedback, and overall quality. At times, we take samples to inform our reporting, but receive no commission from any resulting sales.

Choosing the best vaporizer can at times feel like wading through an ocean. There are multiple varieties, prices, and capabilities, but unless you are a tech expert, multiple controls and functions can be overwhelming.

So why buy a weed vaporizer instead of just smoking cannabis the old-fashioned way? Vaping is likely healthier, especially for the lungs. Additionally, vapes are discreet, create less odour, and allow consumers to optimize the flavour and potency of their weed.

A portable vaporizer is an investment, and the right one can serve you for years to come. In this list, weve curated vapes for concentrates or dried flower, as well as devices that can do both. They are all reusable, rechargeable, and produce vapour (not smoke) via combustion-less technology.

This Canadian-designed concentrates vaporizer is a favourite among many dabbers. Coming in at under $100, its a very budget-friendly option for those looking for a discreet, portable method to consume their stash.

The lithium-ion battery operates for approximately 40 hours off each two-hour charge. There are three variable voltage settings and a 15-second continuous heat option. You can refill the chamber with your extract of choice or use the battery with a 510-thread vape cartridge.

The LED temperature display makes it easy to dial in for perfect terps, and theres a 6-month warranty to keep you covered. It comes complete with an aluminum atomizer globe, two quartz dual coils, two coil caps, a 510 thread battery, a magnetic storage container, a charging cord, and a dab tool.

Find it locally via Leafly or on Shatterizer.com

Designed for use with dried flower, the Airizer Air 2 boasts an isolated airpath and a borosilicate glass vapour path to provide a smooth, flavourful vape with every sip.

Higher-capacity interchangeable batteries make for quicker heat up, while the USB charging makes using it while on the go a breeze. It comes with multiple tubes that you can pre-load so youre always ready for your next hit.

Precision temperature control means you can dial in for specific terpenes, no special app required. Its durable design is backed by a 2-year warranty and comes complete with a belt-clip carry case, stainless steel stirring tool, filter screens, and a sample of aromatic botanicals.

Find it locally via Leafly or on Airizer.com

The G Pen Dash Vaporizer brings supreme functionality to the palm of your hand. This dry herb vaporizer offers a powerful, ultra-discreet, lightweight, and affordable option for newbies and connoisseurs alike.

It features a glass-glazed and stainless steel heating chamber, with three temperature settings. The clean air source and integrated air path make for flavourful sessions. The chamber opening has been ergonomically designed for convenient loading, while the mouthpiece can be taken apart for easy cleaning.

This vape features haptic feedback with three LEDs to indicate heat level and battery life. It comes complete with a G PEN tool and keychain, USB charging cable, and a 1-year warranty.

Find it locally via Leafly or on Gpen.ca

The DaVinci IQ2 uses only medical-grade components, so no metal or plastic parts touch your herb for a pure tasting, flavourful vapour. It boasts an airtight, all-ceramic air path and a glass-lined oven to ensure purity and taste.

It offers a dual-use design for use with dry herb and comes complete with a Dosage Pod for concentrate consumption. The precision temperature control lets you choose from five levels of airflow, and its rechargeable battery heats the device up in just 60 seconds.

There is also a companion app that allows you to input your strain potency and the amount of herb or extracts in your oven so you can achieve your desired dose. Its even available in a selection of colours for a touch of style!

Find it locally via Leafly or on DaVinci.com

The Storz & Bickel Mighty+ improves upon the OG Mighty vaporizer by integrating carefully selected materials and features for everyday use. The makers of the infamous Volcano table-top vaporizer have created a nearly indestructible device for the cannabis enthusiast.

We wouldnt call this a starter vape, this device will last you a lifetime. Features include a ceramic-coated filling chamber, pre-set Superbooster temperate, and even airflow for a perfectly vaped bowl.

The supercharge function that gives you an 80% charge in approximately 40 minutes and the Mighty+ heats up in just 60 seconds. Plus, the brands outstanding quality and functionality are backed by a 2-year warranty + 1 year upon registration.

Find it locally via Leafly or on Storz-Bickel.com

Nicknamed the iPhone of portable vaporizers thanks to its user-friendly interface and ease of use right out of the box, the Pax 3 Complete has been designed for expert use with both dry herb and extracts. Its extended battery life and 2X powerful oven deliver a smooth vapour within 15 seconds, and subsequent heat-ups are nearly instant.

The half-pack lid allows users to measure out dry herb, making it ideal for newbies or those who prefer to vape smaller quantities. Settings can be customized using the companion appincluding adjusting temperatures and dimming the devices LED lights for greater discretion.

Find it locally via Leafly or on Pax.com

Caitlin McCormack

Caitlin McCormack is a writer based in Toronto. Her work has appeared in MSN, Lift & Co., HuffPost, What to Expect, and Mashable, among others. When she isn't writing, she's busy chasing after her two sons, testing out new recipes, and working on her century-old fixer-upper.

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Tokes to-go: Best portable vapes for flower and extracts - Leafly

Nicotine vaping is reportedly gaining ground with latest statistics indicating that over 100 million people are using vaping products worldwide.

This development has given hope to ardent advocates of tobacco harm reduction.

In her contribution to theGFN.TV Commentary on the 16th of June 2022,Executive Coordinator for the Coalition of Asia Pacific Harm Reduction Advocates (CAPHRA), Nancy Loucas, while attributing the rise in numbers of people going for vaping, said the emergence of the Covid-19 pandemic has contributed to the success of their campaign.

It does feel that we are here for good and a lot of it, from me, has to do with things that are happening in the Pacific Region. Pre-Covid, I never would have imagined that we would be sitting here with the Philippines pending, Malaysia going legal on the 3rdof August and possibly with Thailand, actually having regulations. That was the furthest thing from my mind, said Loucas, who was also thethird keynote speaker at the Global Forum on Nicotine 2022 (GFN22).

I do believe its here for good. The advocates are passionate about what they are doing. One of the benefits of Covid is that because we could not get together physically (you know advocacy can take a very long time), the internet has allowed us to get together virtually more often than we would have in person to collaborate and engage with each other. I think that is one of the blessings of Covid and I think that is also helping to make sure that tobacco harm reduction is successful, she added.

This years forum was held under thetheme Here for good!

Loucas accused The World Health Organization (WHO) and its experts of mishandling Covid management.

Its a sad reality. I think the WHO and its experts have lost a lot of their shine by the way they have handled the Covid-19 pandemic, said Loucas.

She, however, disclosed that the mishandling of the Covid-19 pandemic by the global health body is helping them to make inroads in their campaign for adoption and promotion of vaping.

Its helping us in a very strange kind of way and is producing an opportunity. And absolutely, we will take it! Like I said, Covid has brought people together and governments were relying on the advice of these experts to deal with this pandemic which has been completely mishandled, she said.

Another panellist, Karl Fagerstrom a Swedish clinical psychologist observed that majority of the people do not have the social capital to voice out their views and opinions on the matter.

Fagerstrom added that there is no scientific or political capital to win the battle; hence, they have given up the fight.

Even the Tobacco Free Foundation money, which very few have access to, has a very close relationship with the tobacco industry in that they actually give their money from the very beginning in order to influence certain things.

So, in essence, why it is so difficult for many to stand up? Its simply because there is no social capital for it, there is no scientific capital to win, there is no political influence to win. Its almost always a loss unless you are in a group and there is support, he said.

He suspected that majority of the officials at WHO believe that nicotine is a drug and that nicotine is not essential for life; hence, the world does not need it.

Fagerstrom warned that this approach would make harm reduction more difficult and take longer for countries to get rid of nicotine.

They have a very idealistic view of what life is here on earth. Paradise has not occurred here; at least, not the way I see it. And tobacco, alcohol and caffeine have been the most common targets.

What we see in countries, and particularly in the United States with the legalization of marijuana and cannabis, is the use of drugs goes up and the habit of smoking goes down. Its as if there is a transfer from one substance to another.

So, you probably can get rid of one drug and control it if you introduce another one. But is that really what we want? And if would have to choose between smoking between 15 to 20 cigarettes a day and having one or two joints of marijuana a day, there may not be a big difference in harm, he explained.

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Vaping gaining ground around the world with over 100m embracing it - Nyasa Times