In recent years, cigarette smoking has been on the decline. However, another method of inhaling nicotine — as well as many other chemicals — is on the rise. It’s known as vaping, e-cigarettes or e-cigs. Is vaping safe? According to the Centers for Disease Control and Prevention (CDC), vaping has been linked to more than 40 deaths and thousands of cases of lung disease across the United States.
Vaping is the process of inhaling a liquid that has been heated into a vapor. Vaping devices contain a cartridge that holds liquid. When someone inhales on the mouthpiece of the device, it triggers a battery-powered heating element that converts the liquid into vapor, which is then inhaled into the lungs. Depending on the ingredients in the liquid, the vapor may contain a variety of compounds, including nicotine, marijuana derivatives, such as THC and CBD, and countless flavorings, ranging from mint and menthol to fruit and candy.
Initially, vaping was viewed as a potential aid to quit smoking, but the FDA has not recognized it as a valid form of nicotine replacement therapy. Research shows that while vaping has helped some quit smoking cigarettes, some users are now addicted to it.
Moreover, vaping has become a popular behavior with nonsmokers, especially among young users. The National Institutes of Health reports that about 37 percent of 12th graders reported vaping in 2018, compared with 28 percent in 2017.
“Vaping has turned into somewhat of a fad among adolescents,” says Dr. Liang. “The e-cigarette user age is much younger than that of smokers, and the flavorings unfortunately attract a younger population.”
Often, parents have no idea their children are using e-cigarettes. Vaping devices come in many shapes and forms, ranging from easily recognizable cylinders and pipes to devices cleverly disguised as USB drives, pens and lip balms.
In addition, vaping is bad for you. Nicotine is addictive, but most worrisome is the damage vaping may do to the lungs. As of December, the CDC reports more than 2,400 cases of lung disease and 52 deaths associated with vaping,
“Vaping contains so many different additives, and one possible culprit in these lung injuries is vitamin E acetate, which dilutes the e-liquid,” explains Dr. Liang. “In many of those patients, vitamin E acetate was found in their lungs.”
Dr. Liang compares vitamin E acetate to honey coating the delicate lining of the lungs and airways, which interferes with normal lung function. Symptoms of vaping-related lung injury have included coughing, shortness of breath, chest pain and coughing up blood.
“The lung injury is partially reversible and steroids are the mainstay of treatment,” Dr. Liang says. “But we don’t even know what vitamin E acetate does to the lungs as this has never come up before. We think it might cause a severe and rapid airway obstruction and it can also induce lung injury from damaging the air sacs within the lungs themselves.”
While vitamin E acetate seems to be more prevalent in black market and homemade e-cartridges, trace amounts have been found in commercial products as well. What’s more, other potentially deadly additives, including cyanide and pesticides, have been identified in some black market products.
Is there a way to vape safely? The answer is no. At this time there is no oversight as to what goes into vaping cartridges, so you have no real control over what you breathe into your lungs. “Flavorings” may contain a mix of toxic chemicals. Even substances that are safe to use on skin, such as glycerin, are known to irritate the lungs when inhaled.
“I’ve treated people who have almost died from this type of lung injury and it’s been a huge wake-up call for them,” says Dr. Liang. “It’s not worth your lung health or your life to vape, or even try e-cigarettes.”
If you are trying to quit smoking, talk to your physician about safe, proven methods, including FDA-approved nicotine replacement products and cessation programs. Many workplaces offer programs for their employees and families.