EVALI is generally associated with adverse respiratory outcomes including shortness of breath, cough, and hypoxemia. Cases are now being reported in Canada but not in European countries. ![]() Largely confined to the Unites States, over 2000 cases have been reported, and as of January 2020, the Centers for Disease Control and Prevention (CDC) confirmed 60 deaths from EVALI. While the relative newness of e-cigarette use makes discussion about long-term effects difficult, there is a growing body of literature that e-cigarette use may lead to effects that are not dissimilar to cigarette smoking at a cellular, clinical, and population level.Īdditionally, there is now a growing number of health concerns from vaping, particularly over a recent outbreak of severe lung disease (associated with counterfeit vaping products) that has been coined “vaping product-associated lung illness (EVALI) or “vape lung”. Although vaping has been generally recognized as safer than tobacco smoke, in reality, the long-term health effects of e-cigarette use are not known. Moreover, these products have greatly increased in popularity amongst teens and young adults in the United States and Canada. Even if these are more efficacious for certain individuals in comparison to nicotine replacement therapies (NRT), there is little scientific evidence in support of this claim. Because, empirically, there are lower quantities of toxicants associated with combustion, it is believed that these products can be used as a cessation tool for heavy smokers and thus as a way towards greater health improvement. ![]() It is designed to simulate the act of smoking but without tobacco combustion, the latter of which releases thousands of toxicants including many carcinogens. Vaping is the act of inhaling into the lungs the vapor or aerosol that is produced by an e-cigarette. E-cigarettes consist of a rechargeable battery an atomizer (or heating element/coil) and a liquid that contains a solvent (usually propylene glycol (PG) and vegetable glycerin (VG)), nicotine, and various additives including flavors e-cigarettes do not contain tobacco but function to deliver nicotine to the brain. Despite knowledge about the dangers of tobacco and tobacco constituents, we are seeing a surge in the use of emerging tobacco-based products such as heat-not-burn products (IQOS) and e-cigarettes, which are also called vape devices or more formally as electronic nicotine delivery systems (ENDS). Tobacco smoking remains the leading cause of preventable death worldwide and is the single greatest risk factor for developing chronic diseases such as chronic obstructive pulmonary disease (COPD) and lung cancer. Consequently, until more is known about the health effects of vaping, individual factors that need to be taken into consideration include age, current and prior use of combustible tobacco products, and whether the user has preexisting lung conditions such as asthma and chronic obstructive pulmonary disease (COPD). ![]() It is clear there is much about vaping that is not understood. Finally, we outline possible clinical disorders associated with vaping on pulmonary health and the recent escalation of acute lung injuries, which led to the declaration of the vaping product use-associated lung injury (EVALI) outbreak. Here, we review the historical context and the components of e-cigarettes and discuss toxicological similarities and differences between cigarette smoke and e-cigarette aerosol, with specific reference to adverse respiratory outcomes. The long-term health effects are unknown, and emerging preclinical and clinical studies suggest that e-cigarettes may not be harmless and can cause cellular alterations analogous to traditional tobacco smoke. E-cigarette use has rapidly increased among current and former smokers as well as youth who have never smoked. E-cigarette devices can also contain cannabis-based products including tetrahydrocannabinol (THC), the psychoactive component of cannabis (marijuana). Heating this liquid generates an aerosol that is inhaled into the lungs in a process commonly referred to as vaping. ![]() E-cigarettes have a liquid that may contain flavors, solvents, and nicotine.
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