Know Your Vape

Vaping and Respiratory Problems: Unhealthy Effects on US Vapers

By Know Your Vape · · Updated

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Vaping can irritate the airways and is linked to cough, wheeze, and asthma flare-ups, especially in teens. Whether it causes long-term lung diseases such as COPD is not yet known.

The most serious proven harm was EVALI, a 2019–2020 lung injury outbreak tied mostly to THC vapes containing vitamin E acetate.

This article covers the respiratory problems linked to vaping, what the research shows, current US rules, and when to see a doctor. Vaping is not for non-smokers or anyone under 21, the US minimum sales age.

Understanding Vaping and Respiratory Problems

What is Vaping?

Vaping means inhaling an aerosol made by an electronic cigarette. A battery-powered coil heats a liquid that usually contains nicotine, flavorings, propylene glycol, and vegetable glycerin.

Unlike cigarettes, vapes don't burn tobacco. The aerosol generally has fewer harmful chemicals than smoke, but the CDC stresses that "this does not make e-cigarettes safe."

Common Respiratory Problems Associated with Vaping

Cough and wheeze are the best-supported problems. The National Academies' 2018 review found moderate evidence of more cough and wheeze in teens who vape.

Asthma flare-ups are also linked to vaping, with moderate evidence in the same review. People with asthma may find vaping triggers symptoms.

Airway irritation and inflammation can come from chemicals in the aerosol, such as formaldehyde and acrolein, plus fine particles that reach deep into the lungs.

Popcorn lung (bronchiolitis obliterans) is often mentioned, because some e-liquids have contained the flavoring diacetyl. The NHS says vaping does not cause popcorn lung, which has been tied to heavy workplace exposure.

EVALI caused 2,807 hospitalizations and 68 deaths by February 2020. Most cases involved THC products from informal sources.

Long-term conditions such as chronic bronchitis and COPD take years to develop. Studies long enough to show whether vaping causes them haven't been completed.

Health Risks of Vaping

Lung Inflammation

Lab and animal studies show that vape aerosol can cause oxidative stress and inflammation. The National Academies rated the evidence of respiratory harm from these studies as limited.

Chronic Bronchitis

Chronic bronchitis means a long-lasting cough with mucus. Vape aerosol can irritate the airways, but it hasn't been shown that vaping causes chronic bronchitis.

Asthma and Wheezing

Vaping is linked to more asthma flare-ups and to wheeze in teens. If you have asthma, vaping may make symptoms worse.

Popcorn Lung

Popcorn lung is a rare, incurable disease caused by breathing flavoring chemicals like diacetyl at work. Diacetyl has been found in some e-liquids, but the NHS says vaping does not cause popcorn lung.

Increased Risk of Respiratory Infections

Lab studies suggest vape aerosol may weaken lung defenses against germs. Whether this leads to more infections in real-world vapers hasn't been established.

Sharing a vape can spread germs from one person's mouth to another, just like sharing a cup.

Research Findings and Studies

Recent Studies on Vaping and Respiratory Problems

The most complete review is the 2018 National Academies report on e-cigarettes. It graded each finding by strength of evidence:

  • Moderate evidence: more cough and wheeze in teens who vape, and more asthma flare-ups.
  • Limited evidence: respiratory harm in animal and lab studies.
  • Limited evidence: improvement in lung function and symptoms among adult smokers with asthma who switch to e-cigarettes.
  • No available evidence: whether e-cigarettes cause respiratory diseases in humans.

The CDC also warns that using both vapes and cigarettes may worsen respiratory health.

The best-documented case of vaping-related lung damage is EVALI. The CDC linked the outbreak to vitamin E acetate, an additive in some THC vapes, found in lung fluid from 48 of 51 patients tested.

Outside of EVALI, the long-term effects of everyday nicotine vaping on the lungs are still being studied.

For more information on the risks of vaping and respiratory health concerns, please check out our article on vaping health concerns.

Vaping Regulations and Safety Measures

Current Regulations on Vaping in the US

FDA regulates e-cigarettes, e-liquids, and their parts as tobacco products. A company needs a written FDA marketing order to legally sell a new vaping product.

FDA says an authorization does not mean a product is safe or FDA approved. Since December 20, 2019, it has been illegal to sell e-cigarettes to anyone under 21.

Safety Tips for Vapers

  1. Buy legal products from legitimate retailers: Avoid THC vapes and other products from informal sources, which were behind most EVALI cases.
  2. Don't modify products: Never add substances the manufacturer didn't intend.
  3. Follow charging rules: Use only recommended batteries and chargers, charge on a flat surface where you can see the device, and don't charge overnight.
  4. Don't share devices: Sharing can pass germs between users.
  5. Be considerate: Follow local rules on where you can vape, and avoid vaping around children or people with asthma.

Importance of Seeking Medical Help

See a doctor if you have a persistent cough, shortness of breath, chest pain, or wheezing. Tell them what products you use, including any THC products.

A doctor can also help you quit. The CDC notes that counseling plus medication gives adults the best chance of quitting nicotine for good, and free help is available at 1-800-QUIT-NOW.

Conclusion

Vaping is linked to cough, wheeze, and asthma flare-ups, and contaminated THC vapes caused a deadly lung injury outbreak. The long-term effects of nicotine vaping on the lungs are still unknown.

For adult smokers, switching completely is expected to be less harmful than smoking. Dual use doesn't give that benefit.

For non-smokers and young people, the safest choice is not to start. Anyone with breathing symptoms should see a doctor.

Sources

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