Experts Demand EVALI Rename

Posted 21st October 2021 by Dave Cross
Seventy-five multidisciplinary experts have written to the Centers for Disease Control and Prevention (CDC) to get ‘EVALI’ renamed. The letter, sent to Director Rochelle Walensky, includes seven individuals who have served as president of the Society for Research on Nicotine and Tobacco. They believe the linking of the cannabis-related disease to vaping is a mistake and needs to be corrected.

EVALI, otherwise known as “E-cigarette or Vaping Product Use-Associated Lung Injury” came about following a series of hospital admissions due to people using a liquid containing cannabis and Vitamin E acetate – nothing to do with e-cigarettes, e-liquid, or vaping.

The CDC’s website currently states: “National and state data from patient reports and product sample testing show tetrahydrocannabinol (THC)-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online dealers, are linked to most EVALI cases and play a major role in the outbreak.

The letter includes the signatures of leading British-based independent researchers Peter Hajek, Sarah Jackson, Ann McNeill, Debbie Robson, and Caitlin Notley.

They state: “The name EVALI is ineffective and misleading as it does not provide health care professionals or the public with clarity and specificity regarding the sources of risk for these harms. Nor does it make clear what steps to take to reduce the risk of such harms.

“First, ‘e-cigarette’ as used by the public only refers to nicotine vaping products; no THC user would say they consume it with an ‘e-cigarette.’ After the EVALI outbreak and after coverage of the evidence that adulterated THC vaping was responsible, one poll found two-thirds of respondents related the lung disease deaths to use of ‘e-cigarettes such as JUUL.’

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Only 28% related the deaths to use of ‘marijuana or THC e-cigarettes.’ Other research has found similar increases in misperceptions of the risks of nicotine e-cigarettes following the EVALI outbreak and communications about the condition.”

They continue: “Given that the CDC has concluded that the primary drivers of the 2019-20 outbreak of serious vaping lung injuries are THC products that have Vitamin E acetate added, it is critical to focus understanding on these basic facts. In contrast, the CDC has not proven that any human developed EVALI due to nicotine e-cigarettes, and there is significant evidence that nicotine e-cigarettes cannot be a cause of EVALI.”

The authors of the letter contend that a better term would be “Adulterated THC Vaping Associated Lung Injury (ATHCVALI)”.

They continue: “ATHCVALI is also consistent with World Health Organization guidelines on naming diseases, which discourages generic descriptors (such as e-cigarettes, which is not the source of the problem—harmful adulteration in THC products is). Our suggested name ATHCVALI provides important information to manufacturers and consumers that THC vape products can include harmful adulterants, thus encouraging corrective actions from market forces. We considered other names before recommending ATHCVALI, including Vitamin E Acetate Lung Injury (VEALI), which while an unambiguous improvement over EVALI, is perhaps not sufficiently broad since other adulterants in THC vaping products besides Vitamin E can cause lung injury. We are happy to share other naming options with you as well that improve over EVALI, provide scientific information on known risks, and do not stigmatize people trying to use e-cigarettes to quit smoking.”

Ultimately, despite them demanding the disease is renamed and “accompanied by a press release and awareness campaign”, it appears highly unlikely that the CDC will act appropriately.


 Dave Cross
Article by Dave Cross
Freelance writer, physicist, karateka, motorbikes, and dog walker