Heating in Vaping Devices Causes Lung Injury

Nicotine, THC, or Vitamin E oil may not be the primary factor in e-cigarette or vaping product use-associated lung injury (EVALI).
Susan Fourtané
Vaping causes lung inflammation and injury.mauro_grigollo/iStock 

Some smokers think that switching from regular smoking to vaping --a market to reach a value of almost $30 billion at a CAGR of more than 20 percent through 2022-- will let them enjoy their bad-smelling habit without the health risks and deathly consequences of smoking ciggies.

As it turns out, there is no way out. Both smoking and vaping are addictive and have the potential to kill you. They affect your overall health and the health of those inhaling the second-hand, or third-hand smoking coming from the toxic particles your smoking leaves floating in the air.

Another recent report noted that the global market for e-cigarettes is projected to increase more than triple in size since 2020, reaching $59.3 billion by 2027.

Since its appearance on the market, the increase in e-cigarette use, particularly among young people, is a highly dangerous trend with really serious health risks. Market research group Euromonitor estimates that the number of adults who vape will reach 55 million by 2021. 

paper graph
Vaper growth, Source: Euromonitor International 

The United States, The United Kingdom, and France are the three biggest markets. Vapers in the three countries spent more than $10 billion (almost £8 billion, or €8,500 billion) on smokeless tobacco and vaping products in 2018, according to Euromonitor International. 

Vaping shops have become more common in The U.K., with 69 new stores opening on High Streets in the first half of 2019 alone, according to a study conducted by PwC.

The World Health Organization (WHO) has cited several health concerns associated with vaping, including:

  • The long-term effects are unknown

  • Nicotine in the liquid that is vaporized in an e-cigarette is addictive

  • Users replacing the liquid in refillable e-cigarettes might spill the product on their skin, possibly leading to nicotine poisoning

  • Some sweeter flavours of e-cigarettes are irritants, potentially causing inflammation of the airways

According to a JAMA study, about 28 percent of high-schoolers and 11 percent of middle-schoolers now use e-cigarettes. The study was conducted by researchers at the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA). For most of the kids, controversy-prone JUUL was the e-cigarette brand of choice.

Because this is an addictive drug, the side effects caused due to use of e-cigarettes is acting as a restraint on the e-cigarette (vaping) market. The side effects of using e-cigarettes include nausea, vomiting, abdominal pain, itchiness, dry eyes, cough, and nosebleeds. Some of the side effects are caused due to the body's resistance to accept vapor, and may take a few days to disappear.

In a move trying to remain in business, Altria—owner of tobacco giant Philip Morris USA—bought a 35 percent stake in JUUL in late 2018. For some, the move was a clear indication that e-cigarettes are less about quitting smoking and more about hooking a new generation of consumers on nicotine products whilst putting their health at risk. 

Most Popular

Now, new research reveals that effectively, vaping causes lung injury. 

 Vaping causes lung injury

vaping causes lung injury
Vaping is a cause of health risks and consequently, a cause of death, Source: tumsasedgars/iStock 

Early results of a recent experimental vaping study have shown significant lung injury from E-cigarette (eC) devices with nickel-chromium alloy heating elements. The findings were consistent, with or without the use of nicotine, vitamin E oil, or tetrahydrocannabinol (THC), which have previously been thought to contribute to the life-threatening respiratory problem. 

The early results, published in the Journal of the American Heart Association by researchers from the University of California, Irvine (UCI) School of Medicine and the Huntington Medical Research Institutes (HMRI), were observed during a larger study designed to explore the effect of e-cigarette and other vaping product use on the cardiovascular system. The study was funded in part by the National Institute of Health.

The researchers observed eC, or vaping product use-associated lung injury (EVALI) immediately after switching from a vaping device with a stainless steel heating element, to one that used nickel-chromium alloy (NC).

"The results were so impactful, we felt it imperative to release the initial findings early so that electronic cigarette users could be cautioned sooner, especially considering e-cigarette users are at increased risk of Covid-19," said senior author of the study Robert A. Kloner, MD, Ph.D, Chief Science Officer and Scientific Director of Cardiovascular Research for HMRI, and Professor of Medicine at USC.

Robert A. Kloner, MD, Ph.D has run nationally and internationally known cardiovascular research programs for over 40 years, training dozens of medical scientists and collaborating with scores of physician-scientists, numerous research institutions, and medical industries worldwide.

The switch in devices occurred in September 2019, when the eC device the team was using went off market, and a substitute device was offered as an alternative. The new device was physically compatible with the original exposure system, but the heating element changed from stainless steel (SS) to a nickel-chromium alloy (NC).

"Within an hour of beginning an experiment, we observed evidence of severe respiratory distress, including labored breathing, wheezing and panting," said Michael Kleinman, Ph.D, Professor of Occupational and Environmental Medicine at UCI School of Medicine and member of the UCI Center for Occupational and Environmental Health. "After analyzing lung tissue from subjects in the study, we found them to be severely compromised and observed other serious changes such as lung lesions, red blood cell congestion, obliteration of alveolar spaces, and pneumonitis in some cases," Kleinman said.

In addition to Michael Kleinman and Robert Kloner, several researchers participated in the study, including HMRI researchers Jianru Shi, Wangde Dai, Juan Carreno, Jesus Chavez, and Lifu Zhao; and UCI researchers Rebecca Johnson Arechavala, David Herman, Irene Hasen, and Amanda Ting.

In addition to lung injury, inhale apple flavor, exhale toxins and . . . perhaps a virus? 

vaping health risks may include exhaling covid-19
Inhaling apple flavor and exaling what? What vapers exhale might well include a deathly virus coming along with the toxins, which will also affect second-hand smokers, not just vapers /Source: Planet Flem, iStock 

The current research aimed to study the impacts of breathing in e-cigarette vapors on heart function in a well- established pre-clinical experimental model. Over the course of nearly a year, none of the subjects exposed to vapors from the stainless steel devices, both with and without additives, contracted respiratory distress and only one showed a less than 10 percent area of inflammation in the lungs.

Once the new eC device was introduced, affected subjects showed severe respiratory distress, with labored breathing, wheezing and panting. The lung injury occurred without nicotine, THC, or Vitamin E additives; and may also have been related to higher wattage of power settings on the e-cigarette devices. 

These preliminary studies will be followed up with additional future studies to systematically try to determine the cause of the lung problem.

"While further research is needed, these results indicate that specific devices and power settings may play a key role in the development of EVALI as much as the additives do," said Robert A. Kloner. "The harms associated with e-cigarettes and vaping simply cannot be overstated."

According to the study, vaping has been proven to cause increased blood pressure, endothelial dysfunction, and the risk of myocardial infarction and stroke. Heating elements in commercially available eC are usually made of stainless steel, nickel-chromium or nichrome, Kanthal nickel, or titanium.

A new medical condition, which was dubbed e-cigarette or vaping product use-associated lung injury (EVALI) was recognized in The United States in June 2019, and peaked in September 2019. In March 2020, there were about 2,800 U.S. cases of EVALI and 68 deaths reported. 

Patients were typically found to be young males and users of e-cigarettes or vaping products, whose CT scans revealed lung inflammation and injury.

It is important to mention that EVALI can mimic many of the features of Covid-19 pneumonia, and must be taken seriously. In addition, other studies have suggested that smoking, vaping, and second-hand smoke may increase Covid-19 risk. 

Related Articles: 

message circleSHOW COMMENT (1)chevron