Vaping has become America’s latest epidemic, and the number of vaping-related illnesses continues to increase. As of Sept. 24, the U.S. Centers for Disease Control estimated 530 confirmed cases of serious lung illnesses due to the effects of vaping. Nine deaths have been reported.
Dr. Christine Bojanowski, an expert in pulmonary diseases and critical care medicine at the Tulane University School of Medicine, has done extensive research on vaping. She is available to speak about the issue and potential health risks associated with exposure. For interviews, contact pr@tulane.edu or Roger Dunaway at 504-542-2906.
The origin of e-cigarettes:
E-cigarettes were introduced into the international market in 2007 and their evolution has been rapid and dramatic. E-cigarettes, along with vape-pens, mechanical mods, Juuls, e-hookah and e-pipes are all examples of systems that are collectively called electronic nicotine delivery systems (ENDS).
“Typically, these devices contain ‘e-liquids’ or ‘e-juice’ that are heated and then inhaled or ‘vaped.’ Generally, e-liquids contain varying amounts of propylene glycol (PG), vegetable glycerol (VG), nicotine and flavorings. There are well over 5,000 unique flavors available on the market. The origins and quality of these ingredients are not well known and, even when using the same flavor, if produced by different manufacturers, the chemical compositions vary. Furthermore, many vapers mix their own e-liquid in order to modify the nicotine content and may add cannabinoids (natural or synthetic forms of marijuana). Overall, this makes it very difficult for ENDS users to know what they are being exposed to.”
Nicotine exposure:
“Even though ENDS have been promoted as an aid to stop smoking, there is insufficient evidence supporting the effectiveness of e-cigarettes when compared with no treatment or proven cessation treatments. In fact, in many cases, individuals trying to quit smoking conventional tobacco cigarettes by using e-cigarettes as a cessation aid will ultimately become dual users of both products. It is important to note as well that the predominant consumers of ENDS are adolescents and young adults, many of whom never smoked conventional tobacco cigarettes previously. Recent marketing and packaging of these products have been targeting a younger population. The result is that younger people are being exposed to a much higher level of nicotine and developing a more significant dependence at an earlier age.”
How e-cigarettes affects the lungs:
“Researchers have been investigating the effects of vaping on the lung for over 10 years. E-cigarettes have been shown to increase inflammatory response, impair barrier function, decrease cell viability and worsen susceptibility to infection. Most strikingly are the potential effects that are now being recognized clinically. As of September 2019, the Centers for Disease Control (CDC) has reported nine deaths and over 530 cases of vaping associated pulmonary illness (VAPI) in 36 states, with two-thirds of these cases occurring in persons between 18-34 years old. In Louisiana, 13 cases have been reported by the Louisiana Department of Health in persons between the ages of 17-33 years old. Case presentation varies widely. Affected people have described days to weeks of cough, shortness of breath, chest pain, nausea, vomiting, diarrhea, fatigue, headache, and fever. Serious lung diseases including hypersensitivity, chemical pneumonitis, bronchiolitis, lipoid pneumonia, organizing pneumonia, acute eosinophilic pneumonia, acute lung injury and acute respiratory distress syndrome leading to respiratory failure requiring intubation and mechanical ventilation have all been described as being directly linked to vaping. It is becoming increasingly important that physicians are adequately trained in being able to identify cases that are linked to e-cigarette use and that they report suspected cases to the state health department and the CDC.”
What causes lung injury:
“ENDS have been heavily marketed as a 'safer' alternative to smoking conventional tobacco cigarettes. However, the health effects of vaping remain largely unknown and are of increasing concern. The effects do not seem to be infection-related. It is known that there are compounds found in e-liquids that have previously been linked to lung injuries such as Diacetyl (previously linked to cases of ‘popcorn lung’ and severe lung disease) and even heavy metals. Due to the wide variety seen in the composition of e-liquids, it is difficult to say what component or combination of components is potentially the most harmful for the lungs. Therefore, there is no device, composition, flavor or amount that we can say is safe.”
