Vaping and E-Cigarettes: The Hidden Risks

Earlier this year, a 22-year-old man received a double lung transplant after being on life support for 70 days. The North Dakota resident went to the emergency room for a stomachache in October but was instead admitted to the hospital with low oxygen levels and respiratory distress caused by fluid buildup in the lungs. The man reported using e-cigarettes since he was 16 or 17 but had recently started vaping more often. He reportedly had no idea how sick he could get from “just” vaping.

Over the last several years, experts have learned quite a bit about vaping, the process of inhaling heated liquid in aerosol form into the lungs from vapes, mods, e-hookahs, pens and other devices. While each method tends to look a bit different, they all work similarly. The aerosol is inhaled into the lungs where the nicotine and chemicals filter into the bloodstream.

The e-cigarette aerosol that users breathe from the device and exhale can contain harmful and potentially harmful substances, including highly addictive nicotine. A CDC study found that 99 percent of the e-cigarettes sold in the United States contained nicotine. Other substances can include ultrafine particles that can be inhaled deep into the lungs; flavorings such as diacetyl, a chemical linked to a serious lung disease; volatile organic compounds; cancer-causing chemicals; and heavy metals such as nickel, tin and lead.

Vaping Statistics
Anyone can vape, but recent research published by the National Center for Health Statistics says that e-cigarette use is highest among adults 18 to 24 years old. Although vaping is prevalent among young men and women, young men were slightly more likely to use e-cigarettes than women.
What’s even more concerning is that between January 2020 and December 2022, e-cigarette sales jumped by more than 46 percent, an increase from 15.5 million products per month to 22.7 million monthly. One survey of high school seniors found that more than 40 percent had tried e-cigarettes even though it’s illegal to sell e-cigarettes to anyone under 21. Experts generally agree that since most e-cigarettes contain highly addictive nicotine, young adults who use e-cigarettes are at increased risk for long-term effects including lung damage and brain development issues. Other risks of vaping are also concerning:

EVALI
Short for e-cigarette or vaping product use-associated lung injury, EVALI is a serious medical condition in which a person’s lungs become damaged from substances contained in e-cigarettes and vaping products. The vitamin E acetate, an additive in some THC-containing e-cigarettes, is the primary, but not the only, cause of EVALI. The good news is that the number of new EVALI cases has declined dramatically over the last few years, likely due to public health messaging about a link between THC in e-cigarettes and EVALI, and the removal of vitamin E acetate from e-cigarettes.

Bronchiolitis Obliterans
Also known as popcorn lung, bronchiolitis obliterans is caused by the chemical diacetyl, used to sweeten some vape liquids.

Erectile Dysfunction or ED
Another risk of vaping includes the possibility of ED, or erectile dysfunction. According to researchers at New York University, the use of e-cigarettes doubled the risk of ED in men 20 and older, making them 2.4 times more likely to report ED than people who had never vaped.

Fakes
Any person or company can make the vapes and/or chemicals to refill the cigarettes, so when people buy or refill them, the products can be unknown. If the products contain contaminants, it can lead to serious lung injury and body injury in general.

Research
For tobacco, we have lots of information. Approximately six decades of research and rigorous studies have shown which of the 7,000 chemicals inhaled during smoking actually impact the lungs. Since vaping is relatively new, research about exactly how it affects the lungs is in the initial stages. Scientists simply don’t know what the short or long-term effects are yet and which e-cigarette components are the offenders.

Regulation
Laws regulating the use of electronic cigarettes vary widely across the United States. Many experts blame the medical issues suffered from vaping on how loosely the vaping industry is regulated. Companies that make the substances going into the vapes can simply add chemicals to change the flavor or experience. Because vaping businesses aren’t required to reveal the chemicals in these flavors, we simply don’t know the long-term effects of their use. Additionally, since there is less regulation, some of the chemicals used are more likely to be contaminated.

Why Quit?
To some users, it may seem harmless to keep vaping, especially since there is not concrete evidence yet of its actual damages. As researchers continue to investigate exactly how vaping impacts the lungs, the benefits of quitting have distinct and factual benefits, including saving money, improving lung health and giving the heart an immediate boost.

Sources: mdanderson.org, hopkinsmedicine.org, lung.org, nbcnews.com, cdc.gov and health.harvard.edu.