What happens when you vape an E-Cigarette?

What happens when you vape an E-Cigarette?

E-cigarettes or vaping devices are electronic products that heat a liquid or wax to produce an aerosol/vapour/smoke that you inhale and were created as nicotine delivery systems just like cigarettes. They come in many shapes and sizes from looking like cigarettes, to USB flash drives (JUUL), to large tank system devices.

The vaping liquid or wax contains on average 80 different chemicals with most including nicotine and tetrahydrocannabinol (THC) but many also include marijuana, cannabidiol and other drugs.

Other chemicals commonly used include vitamin E acetate5 as a diluting or thickening agent in vaping products, diacetyl7 (banned in UK & EU) and acetyl propionyl7 as sweet flavouring in many vape liquids, Propylene glycol11, 12 which is used as a base.

When the vaping liquid is heated volatile chemical compounds are created1 as well as a number of cancer causing toxins such as Acetaldehyde, Benzene, Cadmium, Formaldehyde, Isoprene, Lead, Nickel, Nicotine, N- Nitrosonornicotine, Toluene2, 9 10 and formaldehyde6.

In addition the heating can add heavy metals such as nickel, tin, lead, aluminium, manganese, choromium and cobalt into the vapour from the heating mechanism3, 18.

The vape aerosol therefore includes all the above as well as ultrafine particles.

The vaper then inhales all these chemicals and elements into their lungs when they inhale.

What does vaping do to your lungs?

What does vaping do to your lungs?

Vaping, as explained above, involves the inhalation of a number of chemicals and elements found in the vaping liquid or wax or created when the vaping liquid or wax is heated. 

Stephen Broderick, Johns Hopkins lung cancer surgeon, says “By now, it seems pretty clear that using e-cigarettes, or vaping, is bad for your lungs. In the last 24 to 36 months, I’ve seen an explosive uptick of patients who vape… we simply don’t know the short- or long-term effects yet and which e-cigarette components are to blame.’21

In January 2018, the National Academies of Science, Engineering and Medicine released a consensus study report that reviewed over 800 different studies and concluded that e-cigarettes [vaping] causes health risks4.

The American Lung Association has stated that the inhalation of harmful chemicals [from vaping] can cause irreversible lung damage and lung disease13.

The impact of E-cigarettes on the lung and health affects are explained below:

Diseases caused by E-cigarettes /Vaping

 

Bronchiolitis obliterans also known as “popcorn lung”

This is a condition that damages the small airways of the lungs resulting in coughing and shortness of breath. It can also lead to chest pain.

This condition can cause lasting damage to the lungs.

It get’s its common name from the fact that it was it was discovered when popcorn factory workers were getting sick. The reason was a chemical called diacetyl that was added to give a buttery flavour.

Diacetyl is banned in the UK & EU but is still added world wide including in the US to vape juices to give a buttery flavour such as in popcorn, custard and sweet dessert flavours.

 

E-cigarette Vaping product use Associated Long Injury (EVALI)

E-cigarette Vaping product use Associated Long Injury (EVALI) which is also called Vaping Associated Pulmonary Injury (VAPI) is an acute or subacute respiratory illness with damage to the lungs that can be severe and life-threatening16, 17, 20.

As of 18 February 2020 there were almost 3,000 hospitalised cases or deaths due to EVALI in the US[19], most of whom were under 35 years old. The age range is not surprising because in US the largest group of vapers are young people.

The vast majority of patients (95%) have coughs, chest pain, and shortness of breath. Additional symptoms include fever, chills, and weight loss (85% of patients), abdominal pain, nausea, vomiting, and diarrhea (77% of patients). These can be the initial symptoms before serious breathing and lung issues are noticed which require oxygen. Symptoms usually progress in severity over one to two weeks

Research showed that all the patients had Vitamin E Acetate in their lungs5 and many had THC in their lungs5 and these are assumed to be part of the cause. In the US Vitamin E Acetate has been removed from some products and there has been a decline in cases19.

 

Chemicals in Vaping liquid and their affect on the lungs

  • Vitamin E acetate5 – this is a toxin of concern to Center for Disease Control and Prevention (CDC), due to its ability to remain in the lungs for long periods of time, and therefore cause complications in the lungs. This may be the cause of E-cigarette Vaping product use Associated Long Injury (EVALI) since all cases of EVALI had this in their lungs19
  • THC5This may be the cause of EVALI
  • Diacetyl7 – High levels of exposure to diacetyl can lead to the serious lung disease bronchiolitis obliterans also known as “popcorn lung
  • Acetyl propionyl7 – known to cause respiratory distress and disease
  • Formaldehyde 21 – This is known to cause lung disease and contribute to heart disease
  • Propylene glycol11, 12 – known to cause irritation to the lungs and eyes and may cause issues for people with asthma and emphysema. In the long term can develop into asthma
  • Volatile chemical compounds14 – can cause eye, nose and throat irritation, headaches and nausea, and can damage the liver, kidney and nervous system
  • Heavy metals3, 18 – these are known to cause respiratory distress and disease. Metal-induced toxicity in the lung can result in long-term scarring of the lungs
  • Ultrafine particles8 – these can be inhaled deep into the lungs and may exacerbate conditions such as asthma and emphysema and could lead to a heart attack

Can your lungs heal after vaping?

If you’ve vaped and/or smoked for a long time you might worry that it’s going to be hard to quit – and also question whether you will get any health benefit and so is it going to be worth quitting? The good news is that the human body is an amazing creation and starts healing in less than 20 minutes after that final cigarette or vape.

After a day the lungs will be cleaning removing the junk left from vaping and cigarettes. Sometimes this manifests itself as a cough – but don’t worry – it’s all part of your body healing itself and getting rid of the junk that’s built up in your lungs.

Between 2 weeks to 3 months after quitting smoking, lung capacity and performance will regenerate and according to the American Heart Association enable intense activities such as running, and the same is true for heavy vapers.

Final Thoughts

Vaping causes lung damage due to the chemicals in the vape liquid, the chemicals created when the vape liquid is heated and the heavy metals from the vape heater that enter the aerosol/gas as you inhale. The good news is that the human body is an amazing creation and starts healing in less than 20 minutes after that final cigarette or vape. You may be interested in these articles:

Vaping Around Kids – Is it safe?

Teen Vaping & How to Help Teens to Quit

Vaping While Pregnant – What are the risks?

Vaping Statistics and Facts

References:

  1. American Cancer society https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/e-cigarettes.html
  2. Henderson, TR; Clark, CR; Marshall, TC; Hanson, RL; & Hobbs, CH. “Heat degradation studies of solar heat transfer fluids,” Solar Energy, 27, 121-128. 1981.
  3. Williams, M.; Villarreal, A.; Bozhilov, K.; Lin, S.; Talbot, P., “Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol,” PLoS ONE 8(3): e57987, March 20, 2013.
  4. National Academies of Science, Engineering and Medicine Public Health Consequences of E-Cigarettes Report – https://www.nap.edu/resource/24952/012318ecigaretteConclusionsbyEvidence.pdf
  5. Vitamin E Acetate as a Plausible Cause of Acute Vaping-related Illness E Bouid, S Patel, A Boudi, C Chan Cureus. 2019 Dec; 11(12): e6350. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952050/
  6. Jensen, R.P.; Luo, W.; Pankow, J.F.; Strongin, R.M.; Peyton, D.H., “Hidden formaldehyde in e-cigarette aerosols,” New England Journal of Medicine 372: 392-394, January 22, 2015.
  7. Konstantinos E. Farsalinos, KE; Kistler, KA; Gilman, G; Voudris, V., “Evaluation of electronic cigarette liquids and aerosol for the presence of selected inhalation toxins,” Nicotine and Tobacco Research 17(2): 168-174, February 2015.
  8. Grana, R; Benowitz, N; Glantz, S. “Background Paper on E-cigarettes,” Center for Tobacco Control Research and Education, University of California, San Francisco and WHO Collaborating Center on Tobacco Control. December 2013.
  9. Goniewicz, M.L.; Knysak, J.; Gawron, M.; Kosmider, L.; Sobczak, A.; Kurek, J.; Prokopowicz, A.; Jablonska-Czapla, M.; Rosik-Dulewska, C.; Havel, C.; Jacob, P.; Benowitz, N., “Levels of selected carcinogens and toxicants in vapour from electronic cigarettes,” Tobacco Control [Epub ahead of print], March 6, 2013.
  10. Williams, M.; Villarreal, A.; Bozhilov, K.; Lin, S.; Talbot, P., “Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol,” PLoS ONE 8(3): e57987, March 20, 2013.
  11. Wieslander, G; Norbäck, D; Lindgren, T. “Experimental exposure to propylene glycol mist in aviation emergency training: acute ocular and respiratory effects.” Occupational and Environmental Medicine 58:10 649-655, 2001.
  12. Choi, H; Schmidbauer,N; Spengler,J; Bornehag, C., “Sources of Propylene Glycol and Glycol Ethers in Air at Home,” International Journal of Environmental Research and Public Health 7(12): 4213–4237, December 2010.
  13. American Lung Association: The Inhalation of Harmful Chemicals Can Cause Irreversible Lung Damage and Lung Disease https://www.lung.org/quit-smoking/e-cigarettes-vaping/impact-of-e-cigarettes-on-lung
  14. American Cancer society https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/e-cigarettes.html
  15. Centres for Disease Control & Prevention – electronic cigarettes https://www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html
  16. Pulmonary illness related to e-cigarette use in Illinois and Wisconsin – preliminary report. Layden JE, Ghinai I, Pray I, et al. N Engl J Med. 2019 
  17. CDC clinician outreach and communication activity. [Nov;2019 ];CDC Clinician outreach and communication activity, August 2019.  https://emergency.cdc.gov/newsletters/coca/081619.htm
  18. Giant cell interstitial pneumonia secondary to cobalt exposure from e-cigarette use. [Dec;2019 ];Elliott DR, Shah R, Hess CA, et al. https://erj.ersjournals.com/content/54/6/1901922. Eur Respir J. 2019 54:1901922
  19. Centres for Disease Control & Prevention – Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
  20. Vaping Associated Lung Injury (EVALI): An Explosive United States Epidemic G Salzman, M Alqawasma, H Asad Mo Med. 2019 Nov-Dec; 116(6): 492–496. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913849/#:~:text=As%20of%20November%205%2C%202019,deadly%20in%20the%20United%20States.
  21. What Does Vaping Do to Your Lungs Johns Hopkins https://www.hopkinsmedicine.org/health/wellness-and-prevention/what-does-vaping-do-to-your-lungs
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