CDE9137: Where There's Smoke, There's Fire! Oral Health Concerns and EVALI (E-cigarette and Vape Associated Lung Injury)

Electronic nicotine delivery systems, electronic cigarettes (e-cigarettes), or vapes are a relatively new product category, which first emerged in 2004. E-cigarettes have been growing in use and are a source of great debate among public health advocates and in the media. Emerging evidence demonstrates that e-cigarettes are less harmful than conventional cigarettes and with the legalization of e-cigarettes containing nicotine, there is improved access to e-cigarettes for current smokers, therefore allowing adults more choice around alternative methods of nicotine intake and/or tobacco cessation. In 2018 the E-cigarette giant, Juul, expanded into Canada, adding a new verb to our Canadian lexicon, “juuling.” Today, with the deregulation of cannabis in Canada and a majority of the United States, many smokers are also reaching for marijuana or THC (tetrahydrocannabinol) to be a part of their smoking regime. Is it true that where there is smoke there is fire?

There have been 1,299 reported cases of people suffering lung injuries after using electronic cigarettes or vaping products in the U.S., along with 26 official deaths. In Canada, as of April 7, 2020, 19 cases of EVALI have been reported to the Public Health Agency of Canada from Alberta (1), British Columbia (5), New Brunswick (2), Newfoundland and Labrador (1), Ontario (4), and Quebec (6). No deaths have been reported.. In October of 2019, the Centers for Disease Control and Prevention (CDC) gave vaping-related illness an official name: e-cigarette or vaping product use associated lung injury, aka EVALI. Given the potential oral health concerns around smoking nicotine, marijuana and now E-cigarettes and vaping, all oral healthcare practitioners need to know the pathophysiology, latest research, symptom recognition and what EVALI treatment currently looks like.

This interactive program looks at some of these most challenging patients, their most common negative sequelae due to drug use and the management of these patients with a particular focus on the dental realm. Case studies will augment the delivery of key points and a problem-based learning approach is encouraged so that each participant’s questions are addressed. Most importantly, you will learn directly applicable strategies to successfully treat these medicallycomplex patients on Monday morning. After all, our goal is to make sure all dental appointments are not just successful and safe for your patient, but also for you and your staff.

EDUCATIONAL OBJECTIVES

1. Recognize the challenges and trends linking the deregulation of cannabinoids, new smoking cessation opportunities and e-cigarette use, 
2. Describe the history of vaping related health concerns and EVALI, 
3. Explain the role of vitamin E acetate in the EVALI outbreak,
4. Summarize CDC treatment recommendations for EVALI,
5. Learn to be a better resource on vaping-related trends for your patients 

COURSE AVAILABLE UNTIL OCTOBER 23, 2026

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