This is What Vaping Does to Your Lungs

According to a Gallup poll, nearly 27 million Americans (8%) aged 18 and older say they smoked e-cigarettes, or vaped, in the past week. That large number doesn’t reflect the 2.14 million high school students and 380,000 middle school students who also report regularly vaping.

To their credit, many vape users choose their electronic device over traditional cigarettes under the perception that it’s safer. However, as research and ER admissions are proving, that perception is seriously misguided.

Like cigarettes, vaping involves inhaling nicotine and other chemicals that can damage the lungs. Lung injuries due to vaping are now so common that they have their own name: EVALI (e-cigarette or vaping product use-associated lung injury). Lest you think EVALI is not that big of a deal, in 2020 nearly 3,000 Americans were hospitalized due to EVALI. Sadly, 68 of those individuals died. 

The cause of EVALI is tied directly to the liquid, or juice, used in e-cigarettes. Most vape liquids are built on two base ingredients: propylene glycol and glycerol. While these ingredients are generally recognized as safe for ingestion, the long-term effects of inhaling these substances are not fully understood. Additionally, some flavorings and additives found in vape liquid may pose additional health risks when inhaled. It's important to note that one common additive— nicotine—is highly addictive and has been repeatedly proven to have negative health effects, including cardiovascular and respiratory disorders. 

While there isn’t a standard test for EVALI, common symptoms that often drive people to see a doctor include: 

• Shortness of breath 
• Cough 
• Chest pain 
• Fever and chills 
• Diarrhea, nausea, vomiting, and abdominal pain
• Rapid heartbeat
• Rapid and shallow breathing 

In addition to a physical exam involving listening to the lungs, measuring blood-oxygen levels, and checking resting heartrate, a doctor may order a chest X-ray or CT (computed tomography) scan to look for spots on your lungs to confirm a diagnosis. Bloodwork may also be done to rule out other possible causes. 

If EVALI is confirmed, initial treatment usually consists of corticosteroids to reduce inflammation in the lungs and, in some cases, supplemental oxygen. If symptoms don’t improve, patients may be placed on a ventilator to assist with breathing.

Because EVALI is so new, recovery is difficult to predict. Some patients respond extremely well to treatment and return to life as usual in a matter of days or weeks. Others may experience long-lasting and quality-of-life compromising after effects. Regardless of how their recovery plays out, all patients are encouraged to speak with a doctor about follow-up and potentially seeing a pulmonologist for ongoing evaluation.

Disha Geriani, MD specializes in pulmonary medicine and critical care at Southwestern Vermont Medical Center in Bennington.