by Victoria De Souza
E-cigarettes may be a possible risk for some new lung illnesses, but the actual cause of these diseases still remains unknown.
With reports of hospitalizations related to vaping, doctors and scientists are scrambling to find the cause.
In the early 1800s, tobacco was one of the most popular vices. Now, in the 21st century, new tobaccoless devices are gaining attention for presenting a negative impact on health.
The marketing of addictions is one of the most lucrative, with around $9.36 billion of profit made in 2017, according to the Centers for Disease Control and Prevention (CDC).
Even though the first attempts of inventing a smokeless, non-tobacco cigarette started in 1963, they became popular around the mid-2000s.
In 2011, after the invention of the first-modern e-cigarette, the use of an electronic cigarette became part of the mass market in the United States.
Vaping is the act of inhaling and exhaling aerosol vapor produced by the e-liquids. Most of the e-cigarettes contain glycol, glycerin, nicotine, and different flavoring liquids.
While there is uncertainty surrounding any health benefit from vaping, e-cigarettes have been promoted as safer substitutes for tobacco. But there has been some concern about manufacturers targeting young adults and teenagers as their main consumers.
With nine confirmed deaths and more than 300 people hospitalized as a result of vaping, the rising visibility of the effects of vaping is causing the health community to question the safety standards of vape consumption and production.
Dr. Ximera Solis, a fellow in Pulmonary and Critical Care Medicine at Texas Tech University Health Sciences Center and University Medical Center in Lubbock, Texas, said little is known about the effects of vaping.
“The fact is that we do not know much about the effects of vaping on long-term and short-term health,” said Dr. Solis. “As far as I know, there is no regulation on these products by the FDA, and a lot of these products are bought from less than credible sources.”
The CDC has issued a warning about the dangers of vaping and recommends that people stop using this product.
Since vaping only has been around for a short period, there is no research on the long-term effects of e-cigarettes.
“Most of the research now is focused on pathophysiology and learning more about vaping in general,” said Dr. Solis.
E-cigarettes can be helpful to ease the process of quitting the consumption of tobacco cigarettes.
“The only ‘advantage’ (to smoking e-cigarettes) is that it does help some people quit smoking regular cigarettes,” said Dr. Solis, “and they can lower the nicotine content over time to wean themselves off this.”
One of the side effects brought about by the use of e-cigarettes is the new development of a lung disease. So far, the CDC has not been able to identify any specific substance that could be the cause of this illness. But it is known that nicotine can cause very damaging effects to the lungs.
One questionable substance that can be found in the e-cigarettes that has come to the attention of medical specialists is tetrahydrocannabinol (THC), which can be found in a variety of e-liquids that can be counterfeited without proper regulation.
The lack of information known about the development of this new illness makes it difficult for medical professionals to provide the correct treatment to be given to the patients.
“What we do know is that the patients become ill very quickly,” explained Dr. Solis. “What is important to realize is that this is a diagnosis of exclusion, meaning that we have to rule out other causes that could explain this symptomatology. Each patient must be treated on a case by case basis. What we do see is that patients have required admission to the intensive care unit, intubation and mechanical ventilation, and even chest tubes for pneumothorax (air in the chest wall from a collapsed lung).”
Dr. Ebtesam Islam from the Department of Pulmonary and Critical Care Medicine of TTU Health Sciences Center and University Medical Center in Lubbock, Texas, explained the inflammation in most of the cases is severe and diffuse, affecting both lungs.
“It is suspected that the formation of an aerosol (i.e. the combustion of the flavoring, nicotine, and other chemicals) causes stress on respiratory epithelial cells by inducing inflammation,” said Dr. Islam. “What we see on imaging, such as Computed Tomography scans or chest x rays, are signs of severe inflammation, like what we would see with infectious processes.”
Dr. Solis mentions the present symptoms are nonspecific for any respiratory illness, such as coughing, shortness of breath, fatigue, fever, and weight loss.
The repercussions of e-cigarettes have been rising, along with lung disease cases. The symptoms of these cases do not match those of cigarette smoking and highlight an entirely new disease.
“Cigarettes tend to cause damage over time, leading to a chronic illness such as Chronic Obstructive Pulmonary Disease (COPD) or Emphysema and takes years to develop,” explained Dr. Islam. “Vaping incidents that are being reported now suggest an acuity to the illness. The time to illness from exposure has varied from days to weeks. With vaping, over two thirds of the patients have been young, between the ages of 18 to 34, and otherwise healthy, and the opposite tends to be true for those with chronic pulmonary disease.”
A focus on treating current cases and the causes of the e-cigarette illness will be the main priority of future research, according to Dr. Solis.
Both Dr. Solis and Dr. Islam agree that vaping should not be taken lightly, and avoiding the usage of e-cigarettes is the safer way until there is more information about the subject.
“These otherwise healthy young adults can present in critical condition, requiring prolonged and repeated intubations,” said Dr. Solis. “Since not much is known about how well these patients would recover, the effects from this illness can be damaging and life-long.”