What you need to know:
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Rare but serious cases of lung damage have been reported in the US.
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Health professionals are concerned about unknown long-term effects.
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Teens may be especially vulnerable to vaping risks.
A 17-year-old girl in the United States was recently diagnosed with “popcorn lung” after vaping in secret for three years. This irreversible condition, known as bronchiolitis obliterans, scars the tiny bronchioles (air sacs) in the lungs, impairing a person’s ability to breathe.
While rare, her case may point to a wider issue. In 2019, nearly 3,000 cases of e-cigarette, or vaping, product use-associated lung injury — EVALI for short — were reported to the US Centers for Disease Control. 68 people died, mostly teens and young adults.
“Occasionally some of the most severe cases make the headlines,“ said Donal O’Shea, a professor of chemistry at the RCSI University of Medicine and Health Sciences, Ireland, “but bubbling underneath all of this is the slow and prolonged damage that vapers are suffering in their lungs.”
Though vaping is sometimes described as a safer alternative to traditional cigarettes, scientists are concerned by how little we know about its long-term effect on lung health.
What happens when you vape?
When you inhale through a vape’s mouthpiece, a battery activates a metal coil that heats the liquid within. This creates an aerosol that is breathed into the lungs.
The vape liquid contains chemicals mixed with nicotine salts and flavorings. These components create thousands of potential chemical combinations when mixed together.
Nobody knows what happens when these heated compounds are breathed into the lungs.
“What has never been tested is to put [these chemicals] into a device and heat them and inhale them,“ said Donal, “how you put a compound or put a chemical into your body is very important upon [determining] how toxic it is.
“What is that chemical going to first meet? It’s going to be sensitive lung tissue that doesn’t repair.
“That’s where this prolonged scarring or damage of lung tissue over many years will ultimately lead to popcorn lung.”
Is vaping bad for health?
Researchers are still learning about vaping’s effects on the human body, but concerning patterns are emerging.
Studies also show vaping causes inflammation in the lungs with users reporting coughing, throat irritation, and shortness of breath.
“Historically it took decades of research to prove that tobacco smoking causes diseases, with the companies who are selling these products denying that they caused harm at all,” said O’Shea.
“Unfortunately, it does appear like we’re allowing history to repeat itself with respect to vaping.”
Scientists and medical professionals are concerned with how little is known about potential long-term health effects. Traditional cigarettes have been studied for decades, with cancer an established outcome. Meanwhile, vapes have gained popularity only in the past decade, meaning long-term effects are less studied.
Risks associated with vaping could also be different in teenagers.
“In teenagers, lung tissue, heart tissue and brain tissue are still developing […] so it’s much more sensitive to damage. And in that way, they are more susceptible to these toxins that they are inhaling,“ said O’Shea.
Nicotine, a key ingredient in most vapes, is highly addictive. Many teens report feeling anxious or irritable within hours of their last vape.
Health professionals are also concerned vapes make nicotine addictions easier. “What we are in fact seeing is that younger people are becoming addicted very, very quickly,“ said O’Shea.
In the 3,000 cases of EVALI in the US, the main death-causing culprit is thought to be vitamin E acetate, a thickening agent. In 2019, researchers found it produces a highly toxic, inhalable gas called ketene when heated.
The Global Picture
Vaping is not just a trend in the US. The World Health Organization reports children worldwide aged 13 to 15 use vapes at higher rates than adults, though comprehensive global data remain incomplete.
A recent study of 25,000 high school students in South Africa found 16.8% use vapes — much higher than the 2% who reported smoking traditional cigarettes.
Vapes appeal to young people through attractive flavors and the widespread belief they are less harmful than traditional cigarettes.
Is vaping a good alternative to traditional smoking?
For adult smokers looking to quit, vapes are sometimes recommended as an alternative. But for non-smokers, especially young people, vaping comes with risks.
“Vaping has […] for quite some time now been proposed as some magic recipe to solve that problem and it clearly is not solving that problem, which is not surprising,” said O’Shea. “It is essentially […] transferring one addiction to another addiction.”
Edited by Matthew Ward Agius
