1 of 22

Vaping & CBD: Facts and Conjectures

2 of 22

e-cigarette, or vaping, product use associated lung injury (EVALI)

3 of 22

CDC.gov

As of Feb 2020, 2807 cases and 68 deaths in the United States

4 of 22

the study of the distribution and determinants of health-related states and events

in specified populations

What is EPIDEMIOLOGY?

5 of 22

the study of the distribution

and determinants of health-related states and events

in specified populations

What is EPIDEMIOLOGY?

(scientific, systematic, and data-driven)

(frequency, pattern)

(causes, risk factors)

(not just diseases)

(neighborhood, school, city, state, country, global).

6 of 22

What do EPIDEMIOLOGISTS investigate?

Environmental exposures

Infectious diseases

Injuries

Non-infectious diseases

Natural disasters

Terrorism & Discrimination

7 of 22

What causes EVALI?

8 of 22

Who constitute the

remaining 45.5%

Why are they vaping?

9 of 22

Percentage of adults in the U.S. who had tried vaping or using electronic cigarettes as of 2018, by age

10 of 22

As of Nov. 2019 There were seven confirmed or probable cases of severe lung illness related to vaping in Canada.

If vaping alone leads to EVALI…

why are cases not reported everywhere?

why now and not back in 2006 when Introduced into the U.S.?

11 of 22

Nov. 2019 CDC identified vitamin E acetate as a chemical of concern among people with EVALI.

Recent CDC laboratory testing of fluid samples collected from the lungs from 29 patients with EVALI

found vitamin E acetate in all of the samples.

Vitamin E acetate might be used as an additive, most notably as a thickening agent in THC-containing e-cigarette, or vaping, products.

12 of 22

CDC recommends that people should not use e-cigarette, or vaping, products that contain THC, particularly from informal sources like friends, or family, or in-person or online dealers.

Where are young people getting their vaping liquids from?

Demand vs Supply

what do we focus on?

13 of 22

Peer pressure

Assertion of Independence

It’s fun

Ignorance

Perception of invincibility

Boredom

Stress coping mechanism

2018

14 of 22

15 of 22

What are the health consequences of legal (non-THC) vaping liquids?

Less harmful than cigarettes, but not completely safe. Long-term effects are unknown.

E-cigarette use may increase transition to cigarettes (4x)

most e-cigarettes contain and emit numerous potentially toxic substances

Dependence on e-cigarettes < conventional ciggs but depends on type of e-cigg

e-cigarette use increases airborne concentrations of particulate matter < conventional ciggs

no available evidence in humans and minimal evidence from animals that e-cigg use leads to cancer

16 of 22

What are the health consequences of legal (non-THC) vaping liquids?

no available evidence whether or not e-cigarettes cause respiratory diseases in humans

moderate evidence for increased cough/wheeze and worsening asthma in adolescents who use e-ciggs

There is conclusive evidence that e-cigarettes can explode and cause burns and projectile injuries.

conclusive evidence that intentional or accidental exposure to e-liquids can result in adverse health �effects and death

There is no available evidence whether or not e-cigarettes affect pregnancy outcomes.

There is insufficient evidence whether or not maternal e-cigarette use affects fetal development

17 of 22

Risk Factors

Domain

Protective Factors

Early Aggressive Behavior

Individual

Self-Control

Lack of Parental Supervision

Family

Parental Monitoring

Substance Abuse

Peer

Academic Competence

Drug Availability

School

Anti-drug Use Policies

Poverty

Community

Strong Neighborhood Attachment

The table below describes how risk and protective factors affect people in

five domains, or settings, where interventions can take place.

18 of 22

Cannabidiol CBD

Derived from either the hemp or marijuana plant –

does not produce a high that THC does.

However, CBD from marijuana “may” contain THC levels in excess of .3%

Marijuana: a Cannabis plant grown for its� intoxicating effect

Hemp: a Cannabis plant grown for many � industrial purposes (e.g. textiles)

Tetrahydrocannabinol (THC): the active � ingredient in marijuana that produces

a “high”

Cannabis: a plant

19 of 22

More Creditable Source lists:

Consumption methods

oil

vape

edibles

capsules

topical creams and patches

managing anxiety, insomnia, chronic pain�certain childhood seizure syndromes*

https://www.health.harvard.edu/

20 of 22

Who uses Complimentary and Alternative Medicine in general?

(2007)

Women

Higher Education and Income

Peaks at age 50--59

In order from most to least:�

American Indian/Alaska native

White

Asian

Black

Hispanic

21 of 22

Why are people using CAM and CBD in particular?

Perception that “natural is safe”

Perception that such treatments have fewer/less severe side effects

Fearful of the well-publicized side effects of western medicine

Hopeful that these therapies will be more effective

Is CBD safe?

Side effects: nausea, fatigue and irritability

�interaction with certain medications (e.g. blood thinners)

FDA does not regulate the safety and purity of dietary supplements

22 of 22