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expert reaction to ongoing deaths and lung injuries being linked to vaping in the US

Responses to further reported cases of death and lung injuries being linked to vaping in the US.


Prof Peter Openshaw, Professor of Experimental Medicine at Imperial College London, said:

“These reports are very worrying, in that it appears to be a newly described disease in distinct clusters. My suspicion is that it will turn out not just to have one single cause, but that cases have come to light that might otherwise have gone unreported because of the widespread public interest.

“There is no doubt that inhaling a range of substances – from diesel particulates to tobacco smoke- risks harming the lung. It is well known that oils such as paraffin can cause problems because they can be inhaled without triggering protective cough reflexes (for example by fire-eaters and those taking liquid paraffin by mouth). Oil particles and oil in water emulsions are prone to cause activation of the innate immune system and are used in some vaccine adjuvants because of this property.

“It seems possible that these case clusters are related to inhalation of oil or oil/water mixtures that cause immune activation and trigger both local inflammation in the lung (pneumonitis) and, in some cases, systemic inflammation. Exactly why and how remains to be determined.

“The risk seems especially great in those adding substances to the manufacturer’s nicotine containing products. While the exact causes are being investigated, it is vital that home-made mixtures of commercial and other products (especially containing any form of oil) are not used in vaping devices.”


Prof Linda Bauld, Professor of Public Health at the University of Edinburgh, said:

“E-cigarettes have been on the market for a decade in the USA, UK and some other countries. Millions of people are using them, in some cases over several years. These reported deaths in the USA from serious respiratory conditions are the first of their kind linked to vaping.

“It seems highly unlikely that widely available nicotine containing vaping products, particularly of the type regulated in Europe, are causing these cases. Although some American authorities remain equivocal, suggesting any vaping may cause this, others are now providing more information and all the evidence to date suggests that illicit marijuana vaping products (THC oils) are the cause. In particular, a compound called tocopherol acetate may be the culprit.

“Authorities who are reacting to these cases by advising no one to vape are by default sending the message to people who have quit smoking through vaping that they should return to tobacco. This is misleading, and potentially irresponsible. Authorities in the USA should be prioritising confirming the causes and addressing this illicit market, not pushing people back to smoking which we know carries multiple risks to health.”



All our previous output on this story can be seen here:

Aug 27:

Sept 6:



Declared interests

Prof Linda Bauld: “Prof Bauld is CRUK/BUPA Chair in Behavioral Research for Cancer Prevention, Cancer Research UK; Deputy Director, UK Centre for Tobacco and Alcohol Studies; and Honorary Professor, University of Stirling.”

None others received

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