What vaping does to your lungs

November 4, 2019 Providence Body & Mind Team

The news is filled with so many stories of vaping causing lung disease that it’s hard to keep up. Find out about more long-term effects on your health.

  • People are having allergic reactions, inflammation and bleeding in the lungs.
  • The chemicals in vape devices are as dangerous as in cigarettes.
  • The long-term risks are being vigorously researched.


The effects of vaping have dominated the news cycle for the last few months as people like 18-year-old Piper Johnson are rushed to the hospital for a lung illness caused by vaping or using e-cigarettes. As of October 2019, Johnson is one of nearly 1,300 cases of vaping-related lung illness reported by the Centers of Disease Control and Prevention (CDC).

The CDC also reported in October there have been 26 deaths among patients who had a history of vaping.

While news reports have focused on the short-term dangers of vaping, more people are calling for research into the long-term side effects, including whether it increases risk for lung cancer.

We spoke with John Handy, M.D., Hon.D., director of the Providence Thoracic Surgery Program, to learn more about the long-term risks of vaping.

How are people getting sick from vaping?

The CDC has named the vaping-related condition EVALI, which stands for “electronic cigarette or vaping product use associated lung injury.” Those who have been hospitalized with suspected EVALI have symptoms similar to the flu or a respiratory virus, such as:

  • Coughing
  • Trouble breathing
  • Chest pain
  • Fatigue
  • Fever
  • Weight loss
  • Nausea, vomiting or abdominal pain

In some cases, the patients have gone on to develop pneumonia, or an infection in the lungs. Others have developed acute respiratory distress syndrome, which happens when fluid collects in the lungs, making it hard for oxygen to circulate through the body.

Doctors and researchers are still trying to figure out precisely what is causing these symptoms, which have been associated with vaping both marijuana (THC) and nicotine. Because the symptoms vary widely from patient to patient, experts don’t know whether the cases are being caused by one illness or several different syndromes caused by inhaling the chemicals.

“When you look at the case reports, they show symptoms of allergic reaction, inflammation, bleeding in the lungs — all kinds of different symptoms, none of which are unified except for the fact that they cause the lungs not to work,” Handy says. “No one knows exactly what’s doing it, that’s the problem.”

The chemicals in vape devices

Vape devices heat a liquid (sometimes called e-juice or e-liquid) and turn it into vapor. People who vape inhale this vapor. The vapor is actually an aerosol, not water vapor, and it contains several different chemicals, including addictive nicotine.

Aside from nicotine, the vapor can also include:

  • Propylene glycol and/or vegetable glycerin – These are used to create the big “clouds” when exhaling, and they have been shown to irritate the lungs and airways.
  • Chemicals for flavoring – Some flavoring chemicals contain diacetyl, which has been linked to bronchiolitis obliterans, a serious lung disease.
  • Volatile organic compounds – These have been shown to irritate the nose, throat and eyes and can damage the kidneys, liver and nervous system.
  • Formaldehyde, acetaldehyde and acrolein – High concentrations of these chemicals can cause short-term side effects, like irritation in the nose and eyes, and long-term effects like lung disease and cancer.

Vape devices and e-cigarettes have a slightly different concoction of chemicals than cigarettes and are not regulated so the manufacturers determine what goes in them.

A 2018 report by the National Academies of Science, Engineering and Medicine stated that e-cigarettes contain several “potentially toxic substances.”The report also said young people who use vape devices are at an increased risk for coughing, wheezing and asthma symptoms.

“Inhaling substances isn’t good for you in the short term or the long-term, be it tobacco, marijuana or vaping,” Handy says. “It’s just not how we evolved, and it’s not common sense to think that it’s somehow good for you.”

What are the long-term risks of vaping?

More research is being done to study the long-term effects of vaping in humans, although recent research showed that e-cigarette vapor caused lung cancer and potentially bladder cancer in mice.

The study, which was conducted at New York University, did not have the mice inhale the vapor (as a human would). Instead, researchers surrounded the mice bodies their whole bodies with vapor.

The researchers acknowledged that the results were not meant to be compared to human disease but does show that “e-cig smoke should be more thoroughly studied before it is deemed safe or marketed in that way.”

“It takes multiple years for us to understand these effects terms of cancer risk, and if something’s only been happening for 10 years, we really don’t know what the consequences are," Handy says.

Can I use vaping as a way to quit cigarettes?

Before the recent outbreak of lung illness, vaping was touted as a safe substitute for cigarettes and a way for people to quit. But with new questions about vaping safety, experts are recommending people use traditional smoking cessation methods.

“I wouldn’t recommend choosing vaping as a way to quit cigarettes,” Handy says. “As a lung specialist, my concern is that people who transition to vaping end up doing both [vaping and traditional cigarettes].”

As of October, the CDC recommends:

  • Do not use e-cigarettes containing THC, as more cases of lung disease have been linked to vape products with THC.
  • Do not use any type of e-cigarette or vape product purchased off the street.
  • Refrain from using e-cigarettes with nicotine.
  • If you are using e-cigarettes to quit smoking, switch to evidence-based treatments such as doctor-provided counseling or FDA approved medicines.

If you have been vaping and develop any concerning symptoms (such as a cough, trouble breathing, chest pain, nausea or fever), see a doctor right away. Your doctor can also support you in finding a safe and proven way to quit smoking tobacco if needed.

Find a doctor

If you need advice on how to quit smoking or vaping, talk to your doctor. You can find a Providence primary care doctor using our provider directory. Or, you can find one in your area.






Can #vaping increase your risk for lung cancer? Experts weigh in on the latest information around vaping safety. #ecigs #lcsm        


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This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

About the Author

The Providence Body & Mind Team is dedicated to providing medically-sound, data-backed insights and advice on how to reach and maintain your optimal health through a mixture of exercise, mindfulness, preventative care and healthy living in general.

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