This article was written by Olivia Goebel, PharmD Candidate.

In September, the first Indiana resident died from vaping-associated lung injury. This is one of 530 confirmed cases and eight deaths in the US of similar lung injury. This non-infectious, toxic pneumonitis can present as acute airway injury, alveolar edema, or respiratory failure. Pulmonary infiltrates are visible as opacities on chest x-rays and as glass shards on chest CT scans. Research by the FDA and CDC is ongoing to identify what induces this alarming injury.

What are e-cigarettes?

E-cigarettes—also known as JUUL, vapes, and vape pens—are battery powered heating elements used for vaping. These elements are designed and marked to look like ordinary objects such as flash drives to increase their appeal and enable their disguise. They vaporize a cartridge of “e-liquid” containing tobacco-derived nicotine and/or tetrahydrocannabinol (THC), along with other enticing flavorings and base chemicals such as propylene glycol and formaldehyde.

E-cigarettes generally contain appealing flavorings such as candy, soda, and fruits. This draws attention of adolescents and young adults to e-cigarettes. Recent surveys indicate one in five high school students has used e-cigarettes. The regulations on e-cigarette products have been poor, but as more becomes known about the potential dangers they possess, legislation to regulate their contents and remove enticing flavorings has been on the rise.

Differences between e-cigarettes and regular cigarettes

There are many differences between e-cigarettes and regular cigarettes. E-cigarettes are considered to have a lower level of toxic chemicals, which is why some individuals consider them safer than traditional cigarettes. However, the list of chemicals in e-cigarettes is generally unknown and poorly regulated.

Another difference between the two is the nicotine content. One cartridge of e-liquid can have as much nicotine as a whole pack of cigarettes. Therefore, to no surprise, the addictive potential of e-cigarettes is high. This is one of the reasons why their use as a smoking cessation tool is not FDA-approved. Although marketed by producers, such as JUUL, as a tool to help current tobacco smokers quit, organizations including the American Lung Association have contradicted these statements and reiterated that evidence-based methods such as nicotine replacement therapy and prescription medications such as Chantix show superior results for smoking cessation.

Risks of E-Cigarettes

We suggest that you discuss tobacco cessation with your medical provider due to the addictive potential and unknown long-term consequences of e-cigarettes. If you have shortness of breath, cough, fever, and/or chest pain and use e-cigarettes, please speak to your provider. You might need to be tested for inflammation in the lungs caused by exposure to chemicals and lipid-based vapors present in e-cigarettes.

As research to understand vaping-induced injury continues, it is important to talk to your provider about e-cigarettes.

You can make an appointment with a Family Health Clinic provider by calling (800) 321-5043.

Resources:

• Christiani DC. Vaping-induced lung injury. N Engl J Med. 2019 Sep 6. Accessed Sep. 19, 2019. DOI: 10.1056/NEJMe1912032. [Epub ahead of print].
• Outbreak of Lung Injury Associated with E-Cigarettes Use or Vaping. Centers for Disease Control and Prevention. Updated Sep. 2019. Accessed Sep. 10, 2019. Available at: https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html#what-we-know
• National Academies of Sciences, Engineering, and Medicine. 2018. Public health consequences of e-cigarettes. Washington, DC: The National Academies Press. doi: 10.17226/24952.
• E-cigarettes. American Lung Association. Updated Aug. 2019. Accessed Sep. 10, 2019. Available at: https://www.lung.org/stop-smoking/smoking-facts/e-cigarettes-and-lung-health.html
• E-cigarettes. American Lung Association. Updated Aug. 2019. Accessed Sep. 10, 2019. Available at: https://www.lung.org/stop-smoking/smoking-facts/e-cigarettes-and-lung-health.html