An epic conference, some reality and the eternal popcorn lung

Some thoughts. Sweden is often held up as a good example of how the use of nicotine can shift from smoking to non-smoking. How this has happened is best illustrated by a visit to the duty-free shop at Landvetter airport - which also happens to be the first stop on Vejpkollen's route to the E-cigarette summit in Washington.

Stopped by the duty-free shop at Landvetter, on my way to Washington and one of several annual conferences on vejpning and e-cigarettes - E-cigarette summit Washington 2025. It will be a day packed with research, policy, debates and wise people. As it should be when it comes to people, addictions, pleasures and problematic markets. The E-cigarette Summit conferences take place alongside a market where solutions can be as controversial as they are effective - or, to put it another way, potentially devastating, repressive and counterproductive. This is the political reality of e-cigarettes and smokeless nicotine. But academia rarely meets the 'reality' it debates. The e-cigarette summit is a way to address this very issue.

But what is the reality of harm reduction in the nicotine market? 

Sweden is often held up as a good example of how nicotine use can shift from smoking to non-smoking. And of course it can be shown in pictures too. The snus and pouch shelf covers well over ¾ of the nicotine section in Landvetter's duty-free shop. E-cigarettes have taken their place just below the cigarettes. A small shelf and it's ok, but not perfect I would say. 

And that is important.

The picture of Landevetter Airport's nicotine supply, despite its flaws (increase the vejp supply!), is quite representative of how we use nicotine here in Sweden. 5% smoke, 2% vejpar and 20% snus (non-tobacco-whites or brown tobacco). And for those wondering (e.g. Non Smoking Generation), this is one reason why the Swedish government has (finally, according to some) started to fight to keep nicotine pouches as an attractive alternative to cigarettes on the market, even within the EU. 

Because in other countries it certainly doesn't look like this, either in the nicotine market in general, and certainly not in shops or in airport duty-free shops.

Popcorn lung - the perfect picture

A key theme of the E-cigarette summit this year is information. How can authorities, health organisations and researchers be more explicit in communicating risks, relative risks and absolute risks to citizens and policy makers? 

Sounds like a perennial theme in this debate and as topical in the US as in Europe and the rest of the world. A good example of this are reports on the link between vejpning and the disease bronchiolitis obliterans, also known as popcorn lung - "popcorn lung". Recently, a Commissioner stood in the European Parliament and ranted that "we have now seen that vejpning causes the disease". Quite absurd.

Bullshit deluxe

For those of us who have followed vejpning as a phenomenon for a few years, we recognise the pattern. Every few years the "popcorn" discussion floats into the media centre lane. There's a picture of a youngster wearing an oxygen mask - angry parents (mostly middle-class) talking about how their unspoilt children have been tricked into believing that "vejpning is harmless" - and doctors warning about flavours and "long-term effects we don't know about". Media gold. Informative rubbish.

Popcorn lung vs Chronic stiff lip?

The fact that popcorn lung is caused by regular vejpning is, fortunately, nothing else than a myth, with no scientific link or evidence. The debate has been going on for almost 15 years, despite the fact that both the British Cancer Society and the British NHS clearly state the reality of the situation. The case studies, which are presented as evidence by some institutes, are exclusively about the use of e-cigs containing cannabis oil - an e-liquid that is manufactured and contains completely different ingredients than a nicotine-containing e-liquid. These are individual cases. It is like comparing apples and oranges.

It has now emerged that the stories are based on Instagram posts that are promoted as truths in "real" media without passing "go". Moreover, the source is often the same PR agency, which is dedicated to turning sordid social media posts into click bait for newspapers. Vejpkollen has written about this beforeand is likely to do so again.

In the US, the nicotine pouches have recently taken off on the market, just like e-cigarettes about 15 years ago The question is, what obscure disease will be attributed to nicotine pouches in the future? I'm guessing something like "chronic stiff lip" or "balloon tongue". What do you think?

Vape safe!

Stefan Mathisson
Travelling editor
Vejpkollen.se
And now also the Danish edition
Vapetjek.dk