5 Pulmonary Concerns in Teens Who Use E-Cigarettes

Coverage of vaping-related illnesses is all over the news – and with good reason. E-cigarettes have been utilized for a while, yet suddenly there has been a dramatic uptick in acute lung injuries. The common thread between these illnesses is that these patients have all recently used e-cigarettes.  

Investigations are ongoing to determine the offending substances and products.  Recently, the CDC found that vitamin E acetate is linked to these lung injuries and they are continuing to run tests to learn more.

As a pediatric pulmonologist, I am naturally concerned. I have always been troubled by teen’s use of tobacco, and especially of the more recent use of e-cigarettes. However, the current surge in lung injuries and deaths related to vaping is sounding alarms: the CDC reports that 14% of e-cigarette or vaping associated lung injuries have happened in persons under the age of 18. Here’s what we know and why we’re particularly concerned about the lungs of teens who vape:   

5 Pulmonary Concerns in Teens Who Use E-Cigarettes

1. Potential for vaping-associated acute lung injury

Patients who have developed this mysterious lung disease have shown signs of severe, acute lung injury or acute respiratory distress syndrome. Usually patients who come to us with an acute lung injury have either aspirated food, inhaled a toxic substance like gasoline, or come down with a severe viral or bacterial infection. Typical symptoms are chest pain, shortness of breath, vomiting, and sometimes fever. 

2. It takes some time to determine what’s going on

It is odd for an otherwise healthy teen to show signs of an acute lung injury, and takes a bit of detective work to determine what’s going on. By running some tests, we must quickly determine that an infection isn’t the cause. Then we’ll ask questions about exposures and behaviors in the previous 90 days. We now have a heightened sense of awareness of vaping in teens and will suspect it when they arrive with any symptoms of respiratory failure.  

3. Its impact on the lungs is devastating

We were only beginning to understand the short and long-term effects of e-cigarettes on young lungs, such as damaging the airways and impeding their growth, before vaping-associated acute lung injuries began. Now we’re seeing the following acute issues:   

• Severe shortness of breath
• Extensive damage that is detectable on x-rays
• Lung function dropping well below 50% of normal
• Excess inflammation in the airway
• Trouble getting oxygen into the blood

4. Some products associated with injury contain THC

Some e-cigarette products contain THC or THC oils, which is the active ingredient of cannabis. Aside from the main issues of teens using cannabis, inhaling these oils into the lungs can cause severe lipoid pneumonia and possibly other forms of injury.

5. We don’t have a specific treatment

We don’t currently have a specific treatment for vaping-associated acute lung injury. Pathology reports show that there’s not just one thing going on and not all cases show exactly the same kind of damage. The best we can do is attempt to remove the offending agent and provide supportive measures, such as mechanical ventilation, oxygen and steroids.

The odds of your teens trying e-cigarettes are high. I urge you to have an open and frank discussion about the risks, particularly with the most recent lung injuries. Ask them if they’ve tried it or are thinking about trying it, and explain how dangerous vaping can be. This post highlights the damage e-cigarettes can do to the lungs; however, further reading explains their addictive properties and potential for toxicity.