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How Unsafe Is Vaping? What to Know About Vape-Related Illness and Death

"First and foremost, people have likely been getting ill from vaping for a long time because vaping is not safe, it is not healthy, and it is not free from danger," said Dr. Rajy Abulhosn, medical review officer for Confirm BioSciences. "Even if you go back to vaping's basic roots as an e-cigarette, this is not a risk-free activity. The recent deaths and illnesses may not be so recent; in fact, it's likely that many people were getting sick and severely ill but we just weren't capturing the association or connecting the dots. People have no clue what they are actually burning when they vape, and there is a large black market as well." Dr. Abulhosn added, "But it’s not just the black market…

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  The E-cigarette or Vaping Product Use–Associated Lung Injury Epidemic: Pathogenesis, Management, and Future Directions

E-cigarette or vaping product use–associated lung injury (EVALI) is a severe pulmonary illness associated with the use of e-cigarettes or vaping products that was officially identified and named in 2019. This American Thoracic Society workshop was convened in 2021 to identify and prioritize research and regulatory needs to adequately respond to the EVALI outbreak and to prevent similar instances of disease associated with e-cigarette or vaping product use.

 EVALI: New Info About Vaping-related Illness

There is likely more than one ingredient in illicit vapes and e-cigs that are causing people to have EVALI. Because there are thousands of products on the market, each vape may affect people differently. This variation in composition makes it hard to accurately identify the root cause of EVALI. Some people who use vapes and e-cigs don’t have any adverse effects, further complicating research into the origin of the illness. Currently, vitamin E acetate is an ingredient strongly associated with EVALI. An oil derivative, vitamin E acetate is a thickener that has been found in over half the products that have caused EVALI. The most common brand associated with symptoms is called Dank Vapes, THC oil products. Exclusive use of THC vapes has been noted to increase risk for EVALI. Other chemicals that have been found in bronchoscopies of EVALI patients are triglycerides, plant oils.

Articles of Interest

E-cigarette or Vaping Use-Associated Lung Injury (EVALI)

EVALI stands for e-cigarette or vaping use-associated lung injury. It was originally known as VAPI (vaping associated pulmonary illness). The new name is in response to a growing number of severe lung illness cases related to using e-cigarette and vaping products, the first being identified during 2019. We are still learning about this disease, so changes may continue to be made to the terminology.

EVALI: New information on vaping-induced lung injury

It has been hard to pinpoint the causes of EVALI. There are thousands of vaping products with varying ingredients, including illicit substances. Most likely, more than one specific product or substance is causing severe lung problems. No one knows why some people get EVALI and others do not, but part of this is probably due to the different ingredients they have inhaled.

UNC Researchers Tackle the E-cigarette or Vaping Product Use–associated Lung Injury (EVALI) Epidemic

“At its core, EVALI is a serious disease that primarily affects the lungs and results in a substantial number of hospitalizations and deaths in a relatively young and otherwise healthy population across the United States,” said Meghan Rebuli, PhD, assistant professor in the Department of Pediatrics in the UNC School of Medicine. “This epidemic is largely caused by the unregulated and quickly evolving nature of the e-cigarette industry and certainly highlights the need for continued action by both researchers and government agencies.”

What We (Still Don't) Know About Vaping

Manufacturers were quick to claim that e-cigarettes were a safer alternative to smoking. Now, amid a glut of vape-related lung ailments, claims of hazards inherent to all vaping are coming just as quickly. Truth is, there are many questions, but few answers.

After six deaths in the US and bans around the world – is vaping safe?

“Tobacco cigarettes cost the smoker one day of life for every four days they smoke,” Britton said. “It is by far in a way the most lethal legal product on the market. It’s inconceivable that e-cigarettes are as harmful as that. “There will be cases of disease caused by vaping but, at the moment, 100,000 people a year die from tobacco. It’s not going to be 100,000.”

An Extensive List of Everything That Might Be Causing the “Vaping Illness”

It’s probably weed cartridges. But maybe not!

Can vaping damage your lungs? What we do (and don't) know

Experts now suspect contamination with a form of vitamin E (called vitamin E acetate) in some tetrahydrocannabinol (THC)-containing e-cigarettes as the cause of EVALI. Other contaminants and other factors (such as pre-existing lung disease) may also play a role.

Everything we know about the outbreak of mysterious vaping-related diseases

Many questions remain about what compounds and in what types of vaping cartridges are causing these acute illnesses, says Sanjay Sethi, chief of pulmonology at the University of Buffalo clinical research office. Some—though not all—of the people who got sick were using vapes that included THC, the main psychoactive compound found in marijuana, according to the CDC.

Health Risks of Vaping - Just How Harmful Are E-Cigarettes?

So while it's safer for cigarette users to switch to e-cigarettes, the health risks associated with vaping can be harmful to your health. If you are not a current tobacco user, it's recommended you don't pick up an e-cigarette in the first place.

How a person vapes, not just what a person vapes, could also play a big role in vaping harm

The way users puff, how long they puff and what they puff all play a role. We do not yet know how this behavior affects how much of each substance vapers consume over the course of their daily lives, but we have reason to believe it is significant.

Identity How Unsafe Is Vaping? What to Know About Vape-Related Illness and Death

Since experts don't know the exact substance causing the illness, they say no form of vaping is totally safe.

If E-Cigs Were Romaine Lettuce, They'd Be Off The Shelf, Vaper's Mom Tells Congress

"These products flooded the market without anyone knowing how they would cause damage, and now we're trying to clean up a mess that involves a cocktail of mystery toxins and proprietary flavors," Johnson said. "If this was romaine lettuce, the shelves would be empty."

THC products were involved in many of the vaping-related illness deaths, officials say

Eighty-four percent of people who died in the outbreak used THC products, according to an analysis of a subset of patients.

The flavoring chemicals in e-cigarettes are linked to a disease known as “popcorn lung”

Researchers at Harvard’s school of public health have published a new study about the safety of electronic cigarettes, and it has nothing to do with nicotine. More than 75% of the flavored e-cigarettes the researchers tested contained the chemical diacetyl, which multiple studies have linked to lung damage.

The Mysterious Vaping Illness That’s ‘Becoming an Epidemic

A surge of severe lung ailments has baffled doctors and public health experts.

The US and UK see vaping very differently. Here's why

"In the UK the culture is that this is a replacement and not an initiation product," said Bonnie Halpern-Felsher, a professor of pediatrics in Stanford Medicine's Division of Adolescent Medicine.

The Vaping-Related Lung Disease Outbreak May Be Coming to an End

The U.S. Centers for Disease Control (CDC) announced Friday with new confidence that vitamin E acetate seems to be largely to blame for the vaping-related lung illness outbreak that swept the country—at the same time it announced the outbreak seems to be approaching its end.

There’s Not Just One Vape Crisis — There’s Three

Furthermore, though it is increasingly looking like traditional e-cigarettes are not driving the current epidemic, there’s an awful lot of ambiguity regarding the potential long-term health effects of vaping, as well as some question as to whether some members of the population may be predisposed to developing such ailments. We know that nicotine is not good for you, and that many e-cigarette products contain higher levels of nicotine than advertised; we also know that e-cigarettes contain chemicals like propylene glycol and glycerine, which, when heated, can release hundreds of VOCs (volatile organic compounds) that may be harmful when inhaled. Indeed, a mouse study in the Journal of Clinical Investigation last month found that the inhalation of such chemicals, even in the absence of nicotine or THC, led to the mice’s lungs developing lipid-laden immune cells, an effect mimicking that of lipoid pneumonitis.

Vaping health crisis: what you need to know

This past year has seen a skyrocketing rate of teen vaping, an outbreak of lung injuries, some serious regulatory shake-ups in the e-cigarette industry, and a whole lot of panic. With so many different vaping crises going on right now, we thought we’d provide a vaping roundup.

Vaping is an urgent threat to public health

If unchecked by strict regulations, the next generation of youth is likely to be the most nicotine-dependent and the heaviest smoking in recent history, wiping out decades of efforts to protect them.

Vaping makes lung bacteria more harmful and cause more inflammation

We urgently need to know more about what the long-term effect of vaping is, not just directly on the lungs but on the bacteria that might contribute to the development of diseases, such as COPD and asthma, so that the public can make an informed choice about whether to vape.

Vaping may be more dangerous than we realized

He and other researchers around the world are now scrambling to figure out what impact this new habit might have on developing bodies and brains in the long term. And they’re finding that e-cigarettes may be more dangerous than we’ve appreciated, especially for hearts, lungs, and brains. There’s also a growing body of research suggesting that vaping can lead to smoking.

Vaping Nicotine Linked To Increased Risk Of Chronic Lung Disease

Many of these acute illnesses are linked to black market THC products, but a growing body of evidence points to the risks associated with vaping nicotine.

Vaping-Related Deaths Fall, But Families Still Look for Answers

Without access to information on confirmed vaping-related deaths, relatives are going to great lengths to find out what happened

Vaping-related lung disease now has a name – and a likely cause. 5 things you need to know about EVALI

Most people with EVALI have either admitted using, or later been found to have vaped products containing tetrahydrocannabinol (THC), the major psychoactive ingredient in cannabis. They have typically purchased these products from illicit sources. Laboratory analyses of THC vaping product samples supplied by EVALI cases have found many of these contain vitamin E acetate (oil). Vitamin E acetate is sometimes added to illicit THC vaping products to dilute and then thicken the liquid to hide the dilution, in the same way other illicit drugs are “cut” with other substances to reduce their purity.

We Finally Have a Clue Why Vapes Are Making People Sick

Vitamin E acetate is an otherwise innocent substance and better known as an ingredient in skin care products and supplements. But it’s also an oil that can turn grease-like and incredibly hot when it’s vaporized. New York State’s Department of Health flagged the chemical as the suspicious link between all sorts of shady THC cartridges months ago.

What We Know About the Vaping Chemicals That Might Be Making People Sick

Vitamin E is an otherwise safe substance found in everyday products like dietary supplements and skincare. But it’s unclear whether it’s safe to vape, especially since it’s not an approved vaping product in New York State. One chemistry professor, Michelle Francl, said the oil is essentially grease and gets very hot before it vaporizes. Once it decomposes, “you’re breathing in who-knows-what,” she told the Post.

What We Know About Vaping-Related Lung Illness

Doctors, officials urge people to stop vaping as they investigate hundreds of cases of pulmonary illness and dozens of people die.

What You Need to Know About Vaping-Related Lung Illness

Coughing, fatigue and shortness of breath are warning signs for anyone who has vaped within the last 90 days.

What's Behind A Cluster Of Vaping-Related Hospitalizations?

Vaping has been linked to a cluster of hospitalizations in Wisconsin, Illinois and Minnesota.

What’s Going on With These Mysterious Vaping-Related Illnesses?

It’s worrisome, yes. But imploring everyone to put down their vapes immediately isn’t really the best way to help. It could even do some harm.

Resources

AVOID

Your organization strives to keep kids healthy. AVOID can help you talk to kids about the risk of vapes using science-based brief educational videos.

Flavors Hook Kids

Flavors mask the harsh taste of tobacco which makes it easier for kids to smoke — and most kids don’t know that flavored e-cigarettes are high in nicotine.

PAVe

PAVe (Parents Against Vaping e-cigarettes) is a grassroots organization founded by three concerned moms as a response to the current youth vaping epidemic, the most serious adolescent public-health crisis our country has faced in decades.

The Real Cost

You already know that tobacco is bad for you, but even experimenting can come with a cost.

CDC

We do not yet know the specific cause of these illnesses. The investigation has not identified any specific e-cigarette or vaping product (devices, liquids, refill pods, and/or cartridges) or substance that is linked to all cases.

StatPearls

Vaping-associated pulmonary injury (VAPI), also called e-cigarette or vaping product use-associated lung injury (EVALI), is an acute or subacute respiratory illness characterized by a spectrum of clinicopathologic findings mimicking various pulmonary diseases.