ALENE PAYNE

One year ago, I took advantage of this space to talk about e-cigarettes and vaping. The amount of available data was slim, and the only recognized health issue related to vaping was bronchiolitis obliterans or popcorn lung. Today, we know that vaping can cause seizures and sudden lung damage, leading to respiratory failure and even death. The name EVALI has been assigned to this epidemic of “e-cigarette or vaping product use associated lung injury.”

Is vaping better for you than smoking cigarettes? Not really, but it depends on what you vape. If you only use tobacco/nicotine/menthol liquids in your e-cigarette, then yes, vaping is marginally better than smoking cigarettes, but neither method is worth the risk. Vaping as a way to stop smoking can backfire. Studies show that the nicotine content in vaping liquids can be double and even triple the nicotine found in cigarettes. You may find that you vape more than you ever smoked, and that you are more addicted to nicotine than ever before.

Is vaping bad for your lungs? Yes, and some vaping liquids are much worse for your lungs than others. The vaping industry has always been quite vocal in stating that vaping liquids are safe enough to drink, which is quite misleading. When you eat, the food goes into your stomach. Your stomach digests the food and gives you energy. If you swallow wrong, this same food can be aspirated into your lungs where it gives you a really bad pneumonia. It just is not the same. Fruit- and mint-flavored vaping liquids are the most dangerous because they contain a variety of chemicals that become toxic when heated and inhaled. These flavors are also the most popular with middle and high school students. The market is flooded with inexpensive and unregulated vaping liquids and e-cigarettes, thus making the practice even more dangerous.

Is smoking and/or vaping marijuana bad for your lungs? Since smoking anything is bad for your lungs, let’s go right to vaping. These types of vaping liquids contain THC, the chemical in marijuana responsible for the “high.” Although some states allow for, and regulate, the production of THC-containing products, growing and processing marijuana remains a cottage industry. Legal or not, people make and buy unregulated THC vaping liquid all the time. One of the most common ingredients in THC vaping liquids regulated or not, is vitamin E acetate. Vitamin E acetate has been found in the majority of THC vaping liquids used by teenagers and young adults presenting with vaping-related lung illnesses. Fatty molecules of vitamin E acetate have also been found in the lungs of several patients who have died from these illnesses.

How bad is the EVALI epidemic? As of Nov. 7, 2,051 cases of EVALI have been reported to the Centers for Disease Control. Cases have been reported from every state except Alaska. The death toll has reached 39 and is spread over 24 states and Washington, DC. North Carolina is not on the list. More than 70% of EVALI patients are male, with a median age of 23 years, but the youngest reported patient was just 13. In terms of EVALI deaths, the youngest victim was 17. In Detroit, another 17-year-old boy received a double-lung transplant this fall due to the sudden damage caused by EVALI. The surgeon stated that the boy’s lungs were so airless and deflated that they did not even show up on the CT scan.

In other words, the results are in. Vaping is the least successful smoking-cessation method. Vaping is bad for your lungs. Vaping THC is bad for your lungs. Vaping does not make you look cool. Believe me, it is hard to look cool on a ventilator because you have EVALI and cannot breathe.

Vaping is just not worth the risk.

Alene Payne, MS, RPC/RRT, is the manager of Cardiopulmonary Services at Vidant Beaufort Hospital.