Latest news with #EVALI
Medscape
6 days ago
- Health
- Medscape
Vaping Epidemic: Are Teens' Lungs at Risk?
Electronic cigarette (e-cigarette) use is rapidly increasing worldwide, especially among teenagers and young adults. Vaping, the inhalation of aerosol from e-cigarettes, has become a common practice, no longer limited to niche groups, said Neena Chandrasekaran, MD, a pulmonologist and critical care physician in Florida, in a video on Once considered a harmless alternative to smoking, vaping has become a global health concern with serious and, at times, permanent consequences. One of the most dangerous is e-cigarette or vaping product use-associated lung injury (EVALI), a potentially life-threatening condition. Vaping can cause serious and permanent pulmonary damage, as seen in the case of David, a 17-year-old student from the US. He had planned to join the Navy, but that dream ended after he developed a severe pulmonary illness associated with vaping. He was diagnosed with EVALI caused by inhaling a homemade liquid containing tetrahydrocannabinol (THC) and vitamin E acetate. David is not alone. In 2020, approximately 2600 individuals in the US were hospitalized with EVALI, and the number has continued to rise. To date, approximately 50 people have died from this condition nationwide. In Europe, additives in e-liquids are more strictly regulated, and no similar cases of widespread EVALI have been reported. However, doctors should remain aware of the symptoms, as the condition can still occur, particularly among individuals who mix their own vaping liquids. Toxic Contents e-Cigarettes function by heating a liquid containing various additives, producing an aerosol that users inhale. Although this may seem harmless, inhaling certain ingredients can cause serious lung damage. Vitamin E acetate is a common and extensively studied additive that is potentially harmful when inhaled. A study published in The New England Journal of Medicine found vitamin E acetate in the bronchoalveolar lavage fluid of patients with EVALI. The authors suggested that vitamin E acetate irritates the lung mucous membranes when inhaled, even though it is considered safe when taken orally. THC, a psychoactive component of cannabis, is also thought to contribute to the development of EVALI. In many cases, high concentrations of THC have been detected in the bronchoalveolar lavage fluid. This suggests that the risk is linked not only to vaping but also to the chemical composition of the inhaled liquid. The diagnosis of EVALI remains challenging. This clinicopathologic syndrome mimics other pulmonary conditions and often resembles atypical viral pneumonia. Common symptoms include shortness of breath, cough, chest pain, and fever. Physical examination often reveals hypoxemia and tachycardia. When patients present with hypoxemia and ground-glass opacities on chest imaging, clinicians often suspect COVID-19 or other viral respiratory infections. EVALI should be considered in differential diagnosis, particularly when patients present with typical viral symptoms but no identifiable infectious pathogens and report using e-cigarettes. Identifying the specific components of inhaled products, such as THC or vitamin E acetate, is essential for accurate diagnosis and appropriate treatment planning. Before confirming a diagnosis of EVALI, other causes must be carefully excluded, including influenza, Streptococcus pneumoniae , Legionella species, and Mycoplasma pneumoniae infections. However, this diagnostic process can be challenging. Certain indications of EVALI include leukocytosis with neutrophil predominance and elevated inflammatory markers, such as C-reactive protein, erythrocyte sedimentation rate, and procalcitonin. Chest radiography is suitable for the initial evaluation; however, CT with or without contrast is often required to identify characteristic imaging findings. Typical CT findings include bilateral ground-glass opacities resembling those seen in pneumonia or diffuse alveolar damage. Differentiation can be difficult because similar imaging patterns are present in various pulmonary diseases. In uncertain cases, bronchoscopy or lung biopsy may be necessary to confirm the diagnosis of vaping-associated lung injury. Treatment and Prognosis The initial management of EVALI generally includes empirical antibiotic treatment as a precautionary measure for community-acquired pneumonia. Systemic corticosteroids are commonly administered concurrently and have demonstrated efficacy in reducing the inflammatory response in the lungs and oxidative stress at the cellular level. Most patients show rapid improvement in oxygen saturation and resolution of pulmonary infiltrates after steroid treatment. In severe cases, such as acute respiratory failure, mechanical ventilation may be required to maintain oxygenation. One case series reported that 56% of hospitalized patients required intensive care, with 27% requiring mechanical ventilation. Approximately 1 in 4 patients developed acute respiratory distress syndrome and required extracorporeal membrane oxygenation in some cases. Despite the potential for severe illness, the overall prognosis is favorable, provided that the diagnosis is made early and e-cigarette use is discontinued immediately. EVALI is a serious but treatable pulmonary condition that should be included in the differential diagnosis of acute respiratory symptoms in individuals with a history of e-cigarette use. Early recognition and prompt cessation of treatment are essential for recovery.
New Straits Times
04-08-2025
- Health
- New Straits Times
MCPF backs Health Ministry's move to ban vape nationwide
KUALA LUMPUR: The Malaysia Crime Prevention Foundation (MCPF) has expressed full support for the Health Ministry's proposed move to ban the sale and use of electronic cigarettes or vapes nationwide. MCPF senior vice-chairman Datuk Seri Ayub Yaakob said an increasing number of non-smokers, particularly youths, are now using vapes, putting them at risk of serious health issues such as persistent coughing, breathing difficulties, and E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI), a condition that can be fatal. "EVALI has already claimed lives in the United States and 41 cases have been recorded in Malaysia since 2019. "The Health Ministry has warned that treatment costs for EVALI-related illnesses could rise to RM369 million annually by 2030, with the current estimated cost per hospitalised patient over 12 days standing at RM150,892.11," he said in a statement today. Ayub said the assumption that vaping is safer than traditional cigarettes is misleading, as vape contains toxic chemicals and high levels of nicotine that can damage the lungs and brain, especially in teenagers. "In reality, electronic cigarettes contain toxic chemicals that cause nicotine addiction, which can damage the lungs and brain, especially among teenagers. "If left unchecked, vape addiction could become as widespread and damaging as drug abuse," he added. MCPF said the Health Ministry must tighten regulations on smoking products through the implementation of the Control of Smoking Products for Public Health Act 2024 (Act 852), and conduct regular monitoring to detect illegal online vape sales targeting youths. The foundation also called for intensified public awareness campaigns across social media and mainstream platforms, with the involvement of influencers, youth leaders and medical experts to share facts about vape risks. "We also urge the authorities to work together to stop the supply and sale of illegal cigarettes, as their presence in the market creates a negative perception of the authorities and the government's efforts in addressing the issue," said Ayub.
Medscape
26-06-2025
- Health
- Medscape
Counsel Patients on Vaping's Irreversible Lung Risks
This transcript has been edited for clarity. Hi, everyone. My name is Dr Chandrasekaran. I'm here today to talk to you about vaping. Vaping has become a global health epidemic affecting everyone from high schoolers all the way to adults. This has gained popularity in recent years, butwhat people don't know is that vaping has now been shown to be linked to irreversible lung damage. It has been linked to conditions such as bronchiolitis obliterans, which is narrowing and scarring of the small airways due to diacetyl, which is found in nicotine liquid in vapes. Also, vaping has been linked to lung collapse,which can then cause hospitalizations and require patients to have chest tubes, or EVALI, which is a significant, life-threatening disease that can leave patients on a ventilator. It's important for us to counsel our patients and to advise our patients that these risk factors do exist when using their vapes every day or even socially on only takes one time to try it to end up with any of these irreversible lung conditions.
Indian Express
11-06-2025
- Health
- Indian Express
Young Edge: Why vaping or e-cigarettes continue to lure Pune young adults despite risks
Written by Siddhi Pati, Despite being banned, vapes are popular among young adults in Pune as many are under the assumption that e-cigarettes are less harmful than traditional cigarettes, while others are simply drawn to the trend under peer influence. Vaping or electronic cigarettes are banned under the Prohibition of Electronic Cigarettes Act (2019). A Kharadi resident, who did not want to be named, said he has several friends addicted to vaping. He added that most people don't think it is harming their health until they start feeling symptoms like throat irritation or a heaviness in their voice. 'Vapes are easy to access, even though they're illegal, since many big smoke shops continue to sell them. I have seen these shops import vapes and e-cigarettes from African, South Asian, and especially Gulf countries,' he said. A student from Viman Nagar shared that there is a perception that smoking is old and unhealthy. 'Even if vaping isn't completely healthy, it feels like a better option, since it also causes less discomfort.' Many users have said that youngsters try out vaping to seek new experiences and later on at least become active tobacco smokers. A student from Kothrud admitted, 'I go to house parties, and even if I don't want to use the vape, it just gets passed around. And I end up smoking it.' A vaping addict pointed out the emotional pressure involved in the process. 'I got into it under peer pressure, and now it has gotten very difficult to quit. And unlike cigarettes, vapes have a variety. So, it's not the feeling of smoking and the nicotine hit. It's also the fact that there is so much more to try. I can carry them everywhere I go. I just need to charge, and it's ready,' she said. Another student from Lohegaon highlighted how easy it is to get hooked, 'I think it's the kick of nicotine that makes vapes so addictive. They are very easily available in every other smoke shop for Rs 2,000–Rs 3,000.' According to psychologists, vapes and e-cigarettes contain addictive chemicals that make quitting hard. 'Many young adults use vaping as a coping mechanism to deal with difficult emotions. Over time, it becomes a habit. They vape when bored, sad, or anxious. Vapes and e-cigarettes are also marketed as sleek and sophisticated, adding to the factor of increased peer-pressure among young adults, and driving them to use these devices,' explained Shreyash Chhajed, clinical psychologist. Health professionals have warned against the common misconception that vaping is a safe alternative. 'They deliver nicotine, which raises heart rate and blood pressure. E-cigarettes also release substances like formaldehyde and TSNAs, which can increase cancer risk. For the lungs, vaping can cause inflammation, oxidative stress, and even conditions like EVALI and 'popcorn lung,' said Dr Vivek Gaikwad, Pune-based cardiologist. The fact that the combination of easy access, peer influence, emotional dependence, and lack of awareness continues to fuel this growing trend is a matter of concern among health experts. Vaping may feel safer than smoking, but the risks are real and rising, they said. (Siddhi Patil is an intern with The Indian Express)
Mint
03-06-2025
- Health
- Mint
How harmful are electronic cigarettes?
RESTRICTIONS on vaping are multiplying. Belgium banned sales of disposable vapes on January 1st. France adopted a similar law on February 24th. Other bans on 'puffs", as these single-use electronic cigarettes are also known, may soon come into force in England, Scotland, Wales and New Zealand. The law in the last of those, which takes effect on June 17th, even prohibits specialist retailers from speaking with existing customers about vaping products. More than 30 countries including Brazil and India have outlawed all vaping products. Are such measures justified? Vaping clearly carries risks. Starting in 2019, America's Centres for Disease Control and Prevention (CDC) began to track a new inflammatory respiratory disease known as EVALI ('e-cigarette or vaping product use-associated lung injury"). As of February 18th 2020, the CDC had identified 2,807 admissions to hospital for EVALI in America. At least 68 of those patients had died. Swift action ensued. Researchers pointed fingers at vitamin E acetate, a skincare oil that was added to many illicit batches of vaping liquids as a thickening agent. When vitamin E acetate is vaporised by a vape's heating coil, highly toxic ketene gas is produced. Many jurisdictions outlawed any addition of vitamin E acetate to vape liquids, and crackdowns on black markets followed. EVALI cases fell sharply; the CDC has not detected a resurgence. Yet health authorities believe EVALI might also be caused by other substances in vape aerosols, including those that are manufactured legally. In a landmark analysis of four popular vaping liquids published in Chemical Research in Toxicology in 2021, a team at Johns Hopkins University labelled six ingredients—including caffeine and tributylphosphine oxide, a pesticide precursor—as potentially hazardous. Earlier studies had found vaping mixtures that used formaldehyde, as well as heavy metals such as chromium and lead. There are other reasons to be concerned. First, as vaping surged in popularity only in the past dozen or so years, cancer cases could still crop up. Lab mice, which can develop diseases quickly owing to their fast metabolisms, have developed cancers after being subjected to vape aerosols. The second is that vape aerosols have been found to damage human tissue, including DNA, via a process called oxidative stress. This sounds grim. Yet researchers mostly concur that vaping is less harmful than smoking. Of the more than 7,000 substances generated by burning tobacco, over 70 have been linked to cancer, and a greater number are toxic. Vape aerosols share some of those carcinogens and toxins, but generally at much lower levels. Crucially, vapes produce no carbon monoxide or tar, two of the biggest nasties in cigarette smoke. A review of 39 studies that was published in January in Tobacco Induced Diseases found 'no significant incident or prevalent risk" of cancer in vapers who had never smoked. What is more, taking up vaping, which mimics smoking gestures, seems to make the latter habit easier to kick. Consider a study of 886 British smokers published in the New England Journal of Medicine in 2019. All wanted to stop smoking. Roughly half were given nicotine via gum, mouth spray, patches and the like. The rest were given nicotine vapes. A year on, 10% of the first group had quit smoking. The figure for those given vaping kits was 18%. And among participants still smoking, the vapers had been lighting fewer cigarettes. Curious about the world? To enjoy our mind-expanding science coverage, sign up to Simply Science, our weekly subscriber-only newsletter.
