Many people opt for electronic cigarettes or “vapes” because they think they’re safer than cigarettes. But there are a growing number of cases of severe lung illness associated with vaping, particularly products that contain THC-emulsified with vitamin E acetate, known as EVALI.
Ninety-five percent of EVALI patients experience respiratory symptoms, such as cough, chest pain, and shortness of breath. Other side effects include fever, chills, and weight loss, abdominal pain, nausea, vomiting, and diarrhea. And as of February 2020, there were over 2,800 reported deaths from EVALI across the United States.
The liquids used in electronic cigarettes mainly consist of solvents, which keep nicotine and flavors suspended and generate smoke plumes.
The most common solvents used are propylene glycol (PG) and vegetable glycerin (VG). While the FDA considers propylene glycol as “generally recognized as safe” for ingestion, its aerosol version hasn’t received the same classification.
Both propylene glycol and glycerol are also known to irritate airways. Exposure to propylene glycol has been linked to chest tightness and wheezing, and symptoms worsen with repeated exposure. Additionally, propylene glycol can cause irritation in the eyes, throat, mucous membranes, and respiratory system, and constrict airways.
Electronic cigarettes are also constructed with various components that can contribute to metal contamination. These include nicotine extract and physical parts of e-cig devices, such as filaments, wicks, sheaths, and joints. Nickel, manganese, zinc, copper, and iron were found to be the most commonly detected metals in e-liquids in high concentrations. Arsenic and other metals or metalloids may also be found. The presence of metals and metalloids in vapes raises concerns, due to their potentially harmful health effects, which may include cancer, heart disease, kidney damage, and neurotoxicity.
Although the flavors used in e-cigs are considered safe for oral ingestion, they may pose risks when inhaled as vapors. Studies have shown that flavorings, especially when heated by the vape device, react with the solvents in e-liquids or form ultrafine particles that irritate and damage the lungs. In addition, benzene, a known carcinogen, can also be formed through the process of converting cherry-flavored vape products from liquid to gas.
Vaping devices contain heating coils and studies have shown that the temperature distribution among the coils is not uniform. This results in “hot spots” and temperature inconsistencies, which can lead to formaldehyde formation. Exposure to formaldehyde can cause irritation to the skin, throat, lungs, and eyes, and repeated exposure has been linked to certain types of cancer.
Electronic cigarette use has been shown to create airway inflammation after just five minutes of use and trigger respiratory reactions like those seen after smoking cigarettes. Chemicals and metals found in vapes are concerning due to their links to serious health concerns. Currently, the long-term effects of vaping haven’t yet been completed, since vaping is a fairly new trend. But as research continues, additional side effects related to years of e-cigarette use may come to light.