![]() Hariri: This study describes four patients with chronic lung disease that was ultimately associated with e-cigarette use. Q: Can you describe your recent study published in the New England Journal of Medicine? With chronic disease, it can be even more challenging to establish a relationship between an injurious agent and disease due to the longer time lag. As we saw with the EVALI epidemic, it took a while to find an association between vitamin E acetate, which was being used to cut vaping fluid products, and EVALI. Hariri: Any time you look at an association between a toxic agent and chronic abnormality, it's challenging because you must establish a temporal relationship and thoroughly evaluate all other potential causes of the abnormality. Q: Why are adverse reactions to toxic agents, such as e-cigarettes, difficult to diagnose? From a scientific and epidemiologic perspective, there is a heavy focus on this topic because there is no data to support that vaping is a safe alternative compared to combustible cigarette smoking, or to better understand what the risks are for those who vape. The EVALI epidemic encouraged many individuals to investigate the long- and short-term risks of vaping. Just before the COVID-19 pandemic, the CDC reported over 2,800 hospitalized e-cigarette or vaping product use-associated lung injury (EVALI) cases or deaths in the U.S., illustrating that vaping use was not "safe" or without risks. However, it's clear that many vaping products are now being used by younger age groups, including at the middle and high school level. Hariri: E-cigarettes were initially developed as a safe, alternative method to help people to quit traditional combustible cigarette smoking. Q: Why are the health risks of e-cigarettes and vaping being increasingly investigated? Hariri discusses how this study paves the way to further understanding the health risks of vaping. The study, published in the New England Journal of Medicine Evidence, determined that vaping was the most likely cause of chronic lung disease in all patients, revealing a histological pattern of small airway–centered fibrosis. Hariri, MD, PhD, pulmonary pathologist in the Department of Pathology and Division of Pulmonary and Critical Care Medicine at Massachusetts General Hospital, and colleagues recently investigated four patients diagnosed with chronic lung disease. Error: Please enter a valid email address.
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