Is vaping dangerous to my health?

Vaping is Dangerous to Health and Can Cause Serious Lung Injury

Vaping is extremely dangerous to your health and can cause severe lung injuries including E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI), which has led to thousands of hospitalizations and multiple deaths. 1, 2

Health Risks of Vaping

Vaping poses significant health risks through several mechanisms:

• Direct lung damage: E-cigarette aerosols contain harmful compounds that can cause:

  • Bronchiolitis obliterans (irreversible lung scarring)
  • Acute respiratory distress syndrome
  • Pleural effusions (occurring in approximately 50% of EVALI cases) 2

• Toxic chemicals: When heated, vaping liquids produce:

  • Pulmonary irritants
  • Carcinogenic compounds (formaldehyde, acetaldehyde, acrolein)
  • Toxic metals (lead, nickel, tin) that leach from heating coils 3

• Harmful additives: Flavoring agents like diacetyl have known pulmonary toxicity with inhalation exposure 3

EVALI: A Serious Vaping Complication

EVALI (E-cigarette or Vaping Product Use-Associated Lung Injury) is a severe condition that emerged in 2019, with the CDC reporting 2,409 hospitalized cases by December 2019 2.

Clinical Presentation of EVALI:

• Respiratory symptoms: Progressive dyspnea, cough, chest pain
• Systemic symptoms: Fever, fatigue, muscle aches
• Gastrointestinal symptoms: Nausea, vomiting
• Can progress to respiratory failure in severe cases 2, 4

Diagnostic Features:

• Bilateral ground-glass opacities on chest imaging
• History of e-cigarette or vaping product use within 90 days
• Exclusion of other possible causes (infection, cardiac, etc.) 4
• Centrilobular ground-glass nodules with subpleural sparing on CT scan 5

Management of Vaping-Related Health Issues

The CDC recommends the following approach for suspected EVALI 1, 2:

1. Complete cessation of all e-cigarette and vaping products

2. Medical evaluation including:

   • Vital signs and pulse oximetry
   • Focused history and physical exam
   • Ruling out other possible causes (influenza, pneumonia)

3. Determine if hospitalization is needed based on:

   • Oxygen saturation <95% on room air
   • Presence of respiratory distress
   • Comorbidities that could compromise cardiopulmonary reserve

4. For hospitalized patients:

   • Diagnostic testing (urine toxicology, infectious disease testing)
   • Chest imaging (X-ray and consider CT scan)
   • Consider specialist consultations (pulmonary, critical care, toxicology)
   • Consider corticosteroid therapy (with caution)
   • Ensure clinical stability for 24-48 hours before discharge

5. Follow-up care:

   • Initial outpatient follow-up within 48 hours of discharge
   • Pulmonology follow-up within 2-4 weeks

Special Considerations for Young People

Vaping has particularly concerning effects on adolescents and young adults:

• Teens and young adults have seen the biggest uptake in vaping 6
• Adolescents with EVALI often present with dyspnea, abdominal pain, and constitutional symptoms 5
• Pulmonary function testing in affected adolescents shows reduced diffusion capacity, obstructive patterns, restrictive patterns, or mixed patterns 5

Important Caveats

• Long-term effects unknown: The consequences of chronic vaping remain largely unknown 6
• Not a safe alternative: Despite marketing claims, vaping is not without significant health risks 6, 3
• Risk of addiction: E-cigarettes often contain nicotine, which is highly addictive
• Risk of progression: Some evidence suggests vaping may lead to traditional cigarette use

The medical evidence clearly demonstrates that vaping poses serious health risks, with potentially life-threatening complications like EVALI. The safest approach is to avoid all e-cigarette and vaping products.