KUALA LUMPUR: Cases of lung damage due to e-cigarette or vaping use-associated lung injury (EVALI) are from the use of prohibited substances found in liquids such as tetrahydrocannabinol (THC), which is cannabis oil containing vitamin E acetate.
This finding was revealed by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) in the United States (US).
Universiti Kebangsaan Malaysia (UKM) health economics specialist from the faculty of medicine Professor Dr Sharifa Ezat Wan Puteh said many parties, including the health community in Malaysia, have misinterpreted the real cause of EVALI, which was previously reported in the US and subsequently spread that information incorrectly.
“This should not happen. As a researcher or individual in health and science, assessments should be made based on facts and evidence.
“Patient history is also very important. For example, if a vape user also uses other prohibited substances in their vape liquids, they may have a long history of smoking and other comorbidities. These facts also contribute to lung damage,” said Dr Sharifa, who is also the Malaysia Society for Harm Reduction chairman and a community health physician.
“If we look at the facts from the US, the cases that occurred as of February 18, 2020, were 2,807 lung injuries related to the EVALI, which ultimately resulted in 68 deaths in 30 states.
“Of the 2,022 patients treated at the hospital, 82 per cent reported using products that contain prohibited substances, namely THC, which contains vitamin E acetate.
“Authorities in the US have linked the EVALI cases to this fact. However, it has been ignored by many parties,” she said in a statement today.
Dr Sharifa said vitamin E is widely used in food and cosmetics. It is a safe substance to be in contact with skin but not to be inhaled.
She added that EVALI had only been reported in the US, with no subsequent cases reported after that.
There are no reports of EVALI in other countries. However, comprehensive information must be carefully evaluated, or we risk making biased decisions.
She said that for those who do not smoke or have successfully quit smoking, there is no need for them to start using vaping.
Dr Sharifa further said that EVALI occurred because enforcement for vape products in the US is low, and there are no strict controls in place, making it a product easily accessible by the underaged.
This also facilitated the abuse of drug substances in vaping.
Following the EVALI cases, legislation in the US was tightened, and enforcement stepped up, with access to flavours in vape liquid controlled.
Simply put, vaping is not for those who have never smoked or those underage.
Undoubtedly, the use of vape affects the health of users. However, compared to tobacco cigarettes (which involve burning), the risk is lower, as vaping does not produce thousands of chemicals or carbon monoxide.
Several international studies have also shown that cigarette addiction, mixed with tobacco’s many chemicals, will severely increase addiction and make it more difficult to recover from such an addiction.
If vape is used within proper parameters, without any substance abuse, such as in the case in the US, it can benefit users, especially smokers who are looking to quit.
For example, in Europe, Canada, and the United Kingdom (UK), vape liquids undergo strict screening by independent laboratories and are then accredited by their respective governments.
In these countries, there is no evidence of EVALI.
In fact, evidence and studies show that smoking rates in these countries have declined.
Dr Sharifa added that no EVALI cases have been detected or reported in other countries, including Malaysia, due to the ‘normal’ vape use.
While this could be due to the lack of surveillance, she reiterated that there is no accurate patient history, including a history of chronic smoking.
She argues that if vaping is allowed to be used amongst smokers, it can provide benefits in reducing tobacco harm and lowering the number of smokers.
This is in line with the progress of other developed countries such as New Zealand, Japan, and the UK, which have recorded a decline in smoking prevalence, with smokers switching to less harmful vaping.
However, just like in the UK, there still needs to be another step for vape users so that they receive proper education on the use of vape and can quit totally in the end.
“Based on estimates, the rate of smokers in Malaysia will decrease from 4.88 million in 2019 to 4 million in 2025 for various reasons, including the use of vape.
“These statistics are in line with data from several countries that allow the use of vape as a strategy to reduce the risk of tobacco, in addition to nicotine replacement therapy.
“This is an undeniable fact, as currently, more and more smokers are switching to vaping in Malaysia to quit smoking. However, these products need pragmatic regulation and control,” she said.
New Straits Times – 2022-06-21.
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