A few cases similar to the lung disease EVALI, normally associated with THC-vejpning, have been recognised in Finland over the past year. This is according to Swedish YLE. The newspaper does not disclose the number of cases and says doctors cannot determine whether the illnesses are linked to e-cigarette use. But speculation suggests that this could be one of the causes.
"We know that these are young people and that they have vejpat, that's a common denominator" says Dr Terttu Harju.
EVALI is a lung disease caused by a person inhaling so-called lipids, fatty substances that stick to the lungs. This in turn can cause chemical pneumonia. The disease got its name "E-cigarette and Vaping Associated Lung Injury" in 2019, when nearly 3,000 people were treated for lipid pneumonia in the United States after using vejp products containing cannabis (THC) in combination with the oil-like substance e-acetate.
Linked exclusively to cannabis
E-acetate was used in illegal production of thc-vapes and flourished for a short period on the black market in the United States, as a cheap alternative to legal cannabis vapes. Few cases were reported outside the US, but two incidents was recognised in Sweden in 2020.
E-acetate and other lipids are used not in the manufacture of nicotine vapour and according to Swedish YLE, Finnish doctors are not able to test for specific EVALI.
Chose vejpning as the reason
The doctors YLE spoke to did not specify what the affected patients have vejpat or where the e-juice comes from. However, according to the doctor, these are relatively young people who report that they vejpat Terttu Harju.
"And if no other cause has been found and vejpning is present in the patient's history, then it has been concluded that it is lung damage caused by vejpning," says Terttu Harju to YLE.
Widespread use among young people despite ban
Currently, the sale of non-mint flavoured e-liquids and artificial tobacco is prohibited in Finland, as are online sales and imports. The same applies to disposable models. Despite this, the use of vejp products among young people is as high as in other countries where the products are authorised. The black market is large, something that Finnish customs and police authorities have long warned about.
"Ignorance of vejpning behind diagnosis"
According to Jari Ollikka, Spokesperson for the Finnish User Association Vapers Finland, it is highly unlikely that the cases in question can be linked to the use of controlled products. At the same time, he notes that the doctors' statement in YLE leaves much to be desired.
"It sounds like a very strange way to make a diagnosis. It could just as easily be ordinary pneumonia caused by seasonal flu, something they don't seem to have taken into account when they made their public statements. Just because they do not understand what caused the inflammation, one concludes that it must be about ordinary e-cigarette use. It shows prejudice and deep ignorance about vejpning," he told Vejpkollen.
EVALI disappeared quickly
At present vejpaking over 100 million people around the world and it was only for six months in 2019 that EVALI ravaged several US states. Soon after American FDA that the category of cannabis vapour with e-acetate was the cause of the illnesses, the number of cases fell as dramatically as they had arisen. Only a few cases have been reported since then.
Clear advice for treatment in Sweden
According to Swedish Poisons Information Centre it is important that doctors keep track of EVALI. If young healthy people present with abdominal pain, nausea, vomiting, general malaise and increasing shortness of breath or dyspnoea, and report recent e-cigarette use, doctors should enquire whether the patient has vejpaken any form of cannabis liquid and also whether the product is from the US market. Advice is also given to GPs:
"Many patients have responded well to treatment with corticosteroids used in doses of around 120 mg methylprednisolone per day divided into 2-3 doses. 95 % of the cases have needed hospitalisation, in many cases in intensive care. The supply of oxygen is often necessary, in several cases via a ventilator and in a number of cases with a heart-lung machine (ECMO). Over eighty percent of EVALI cases are under 35 years of age," write Erik Lindeman and Anna Myrnäs, both senior physicians at the Poisons Information Centre
