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After reading this study, I don't think the authors have presented any compelling evidence for their hypothesis re: EVALI outbreak. And actually I see a lot of red flags. https://twitter.com/myharmreduction/status/1310694456740503555
First problem: They have not done a good job reporting their design and methodology. While they do report materials and device wattage I don't see any info on the resistance of the coils they tested. They are also pretty vague about the operating conditions.
This matters cos running coils in inappropriate operating conditions will burn them. Vapers experience this as "dry hit." In people, the shockingly bas taste (& feel) of vapor from burned coils precludes inhalation, especially repeated inhalation toxins produced by the user error
"dry hit" has been known to people who use e-cigs since first days of the tech. But there's also a considerable literature on the implications of this phenomenon for emissions studies (machines can't taste a dry hit, & "vape" whether operating conditions reflect reality or not)
Which brings me to an additional red flag: I see no references to any of the key studies on dry hit, or to any of the major relevant studies in the emissions literature in this paper. It makes me wonder if the authors are familiar with the research relevant to their work at all.
This wouldn't be the first time that enterprising researchers with a tobacco control grant but no practical knowledge or experience with the technology, burned coils and attributed a hazard caused by user error (undetected due to their design) to normal operation of the machines.
Am I sure that's what happened here? No. They dont disclose enough info for someone literate in ecig emissions science to know if the study is any good.
But the (likely) alt. explanation isn't even the main reason I don't think the authors explanation in this paper is valid
But the (likely) alt. explanation isn't even the main reason I don't think the authors explanation in this paper is valid
Side note: They didn't design the study to test a hypothesis about evali & different coil materials. As I understand, it was a 'bug' (having to use different coils due to availability) that created a comparison group & differences in these rats is now being explained post-hoc.
Not that 'bugs' arising in the research process can't serendipitously lead to groundbreaking scientific discoveries. But usually, bugs are just bugs & their weird results should be interpreted cautiously. To paraphrase Feynman: resist fooling yourself, you are the easiest to fool
Anyway back to the paper. The post hoc hypothesis is that "EVALI" may be independent of substance. this is based on an observation that rats administered vapour from a "new" (to the experiment) coils developed inflammation similar to EVALI & not seen in rats that got diff coils.
One major problem is that while rats, like EVALI patients, dev'd symptoms of ARDS, nothing else fits with the epidemiological picture of the ARDS "outbreak" known as "EVALI". (Remember acute respiratory distress syndrome, a diagnosis of exclusion isn't objectively verifiable)
Importantly, while nichrome coils did seem to harm more rats (in vague operating conditions we know little about) than stainless steel, they're not new, are extremely common & used by vapers around world (including highly regulated environments like europe) way before EVALI
The EVALI outbreak was limited almost entirely to the United States, and most cases are connected to illicit market cannabis products. The timing corresponds with the introduction of vitamin e acetate into illicit cartridges sold in america.
Anyway, this study came on my radar via someone I 
, which reminded me that it takes a lot of of product specific knowledge to recognize some of these problems (even though they are obvious to many politically active vapers). So I figured it was a good candidate for unpacking.
, which reminded me that it takes a lot of of product specific knowledge to recognize some of these problems (even though they are obvious to many politically active vapers). So I figured it was a good candidate for unpacking.
EVERYONE STOP WATCHING THE DEBATE, I TWEETED.
