Vaping and Pneumonia: Uncovering the Unhealthy Connection

Vaping has not been proven to raise the risk of ordinary infectious pneumonia, but it can injure the lungs. The clearest example is EVALI, a 2019–2020 outbreak of serious lung injury that sent 2,807 people to the hospital.

Pneumonia is an infection that inflames the air sacs in the lungs, which can fill with fluid or pus. It causes cough, fever, and trouble breathing, and it can be life-threatening.

This article covers what the research shows, how vaping might affect lung defenses, and when to see a doctor. Vaping is not for non-smokers, pregnant people, or anyone under 21, the US minimum sales age.

The Link Between Vaping and Pneumonia

The strongest evidence linking vaping to pneumonia-like illness comes from EVALI (e-cigarette, or vaping, product use-associated lung injury).

EVALI is a lung injury, not an infection, but it is a serious breathing illness that put people in the hospital. By February 18, 2020, the CDC had counted 2,807 hospitalized EVALI cases and 68 deaths.

Lab data strongly linked the outbreak to vitamin E acetate, an additive in some THC vaping products. Most patients had used THC products from informal sources such as friends, family, or dealers.

For ordinary infectious pneumonia, the evidence is less clear. The National Academies' 2018 review found no available evidence on whether e-cigarettes cause respiratory diseases in humans, and only limited evidence of harm from animal and lab studies.

That doesn't mean vaping is safe for your lungs. It means long-term studies in people are still underway.

Researchers have proposed several ways vaping could make lung infections more likely. Most of this comes from lab and animal studies, so it shows what is plausible, not what is proven in people.

Impact of Vaping on Lung Function

Vape aerosol can irritate the airways. The National Academies found moderate evidence that teens who vape have more cough and wheeze, and that vaping is linked to more asthma flare-ups.

Irritated, inflamed airways may be less able to clear germs.

Weakening of the Immune System Due to Vaping

Some chemicals in vape aerosol, such as formaldehyde and acrolein, can cause oxidative stress and cell damage. Lab studies suggest this could affect the cells that help defend the lungs against infection.

Whether this leads to more pneumonia in real-world vapers has not been established.

Inhalation of Harmful Substances in E-Cigarette Aerosols

The CDC says vape aerosol can contain nicotine, cancer-causing chemicals, heavy metals such as nickel, tin, and lead, volatile organic compounds, and tiny particles that reach deep into the lungs.

Adding substances the manufacturer didn't intend, as happened with vitamin E acetate in EVALI, can be especially dangerous.

Case Studies and Real-Life Examples

EVALI is the best-documented real-world example. Every one of the 2,807 cases counted by the CDC was serious enough for a hospital stay, and 68 people died.

Doctors have also published individual reports of lung inflammation in people who vape. Single case reports can't prove cause, but they help doctors know what to watch for.

The CDC still warns against using THC vapes from informal sources and against adding anything to a vape.

If you vape and develop a cough, shortness of breath, chest pain, or fever, see a doctor and tell them exactly what products you use.

Health Risks and Prevention

Pneumonia is not the only concern. Vape aerosol contains chemicals that can irritate the lungs and affect the heart and blood vessels in the short term.

The CDC says the aerosol generally has fewer harmful chemicals than cigarette smoke, but "this does not make e-cigarettes safe." Using both vapes and cigarettes may worsen respiratory health.

Nicotine is highly addictive, and the long-term effects of vaping are still unknown.

To lower your risk:

Don't vape if you don't smoke: The CDC and FDA both say people who don't use tobacco should not start. Learn more at Know Your Vape.
Avoid THC vapes from informal sources: These were behind most EVALI cases.
Don't modify products: Never add substances to a vape that the maker didn't intend.
Talk to your doctor: Ask about your lung health and about vaccines that protect against pneumonia, such as flu and pneumococcal shots.
Get help to quit: Call 1-800-QUIT-NOW for free coaching, or ask about FDA-approved quit medications.

Conclusion

Vaping can injure the lungs. EVALI showed how dangerous contaminated THC vapes can be, with thousands of hospitalizations and dozens of deaths.

Whether everyday nicotine vaping raises the risk of infectious pneumonia hasn't been proven yet. Lab studies suggest it could weaken lung defenses, so the risk can't be ruled out.

For adults who smoke, switching completely to vaping reduces exposure to many toxicants in smoke. For anyone who doesn't smoke, the safest choice is not to vape.

For more information on the risks of vaping, please visit KnowYourVape.com where you can find valuable insights into the dangers of vaping, long-term effects, and other vaping health concerns.