Electronic cigarettes were advertised as an alternative to traditional tobacco that could help quit smoking, however, experts warn that they have health risks, and the appearance of EVALI, a serious lung disease, is further proof. EVALI is the name of a disease characterized – as its acronym in English indicates – by lung lesions associated with the use of electronic cigarettes or vaping, which can begin to occur days or weeks after starting vaping and are potentially fatal.
“We are consuming a product that generates lung inflammation,” explains Dr. Allam Sam, a pulmonologist at MD Anderson Cancer Center Madrid. In the event that it contains nicotine, nicotine is a recognized carcinogen, but, even if it is not carried, a tobacco heater or a vape can generate formaldehyde, which is another known carcinogen, and, above all, generate lung inflammation.
In fact, the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) has prepared a position document in which it warns that e-cigarettes and tobacco products for heating are not safe, are addictive and are not effective for quitting the habit. : “Harm reduction is a false solution, as it represents a commercial strategy of the tobacco industry to increase its sales, making it difficult to control smoking, since it retains smokers in tobacco consumption and prevents them from making serious attempts to quit . In addition, these products are a gateway to adolescents in tobacco ”, he points out.
Why vaping can cause EVALI
“EVALI is a process that occurs with fatigue, with a decrease in respiratory capacity, which can cause fever and loss of oxygen in the blood, and which is mainly caused by an inflammatory process that is triggered when products containing oil are used. vitamin E in vapers. In the United States, it was closely associated with the use of products containing cannabinoid oils in traditional vapers. However, the vaper itself can cause lung inflammation, that is, the EVALI would mean the maximum inflammation that a vaper can produce, but in all people who vape, regardless of whether they vape with nicotine or without nicotine, it produces inflammation lung to a greater or lesser extent. EVALI would be the last process, which may even require a lung transplant”, says Dr. Sam.
“EVALI is a serious disease that requires ventilatory support with high-flow oxygen, corticosteroids, and autonomous recovery of the respiratory system”
Therefore, the appearance of EVALI has been linked to the vitamin E oil that is sometimes used to thicken vaping products. Consuming vitamin E in the form of food supplements is safe, as is its use in skin care products, but if inhaled it can impair lung function.
Chemicals, vapors, and metals can also cause lung damage, and the liquid form of some substances is altered by becoming a vapor, generating new toxic chemicals that were not in the liquid, and can also interact or combine with other substances. chemicals and cause more damage.
From SEPAR they insist on its damages: “heated tobacco and electronic cigarettes, despite being less toxic than conventional tobacco, does not imply that they do less harm, so a regulation identical to that applied to that is necessary. ”.
EVALI symptoms and how it is diagnosed
Lung damage from EVALI may initially manifest with flu-like discomfort, which can quickly worsen and cause symptoms such as:
- Coughing or breathing difficulties.
- Pain in the chest or abdomen.
- palpitations.
- Fever and chills.
- Excessive tiredness.
- Loss of appetite or weight for no reason.
- Fatigue
- Nausea and vomiting, or diarrhea
- confusion or agitation
Symptoms can vary in severity, and some people may develop pneumonia or respiratory failure. It is important to seek medical attention immediately if these symptoms are experienced after using a vaping device.
“EVALI is a disease that was detected by discarding; that is to say, when people who suffered from an acute pulmonary inflammatory process and who did not have a previous respiratory infection or previous lung pathology were screened for known diseases, the only factor associated with pulmonary inflammation was that they had used vapers,” says Dr. Sam.
The pulmonologist explains that the disease is usually diagnosed with a test called bronchoalveolar lavage in people with inflammatory processes of the lung parenchyma or respiratory tract, who have a lot of inflammation and no previous inflammatory, infectious, or oncological cause is found, or something that produce lung inflammation, such as pneumonitis. “When performing bronchoalveolar lavage, certain findings are found that suggest that there is a hyperacute inflammatory process produced mainly by exposure to these oils and gases.”
EVALI treatment for vapers
Regarding the treatment of EVALI, he points out that patients generally must be hospitalized because “it is a serious disease that requires ventilatory support with high-flow oxygen – that is, not even the usual oxygen with the nasal prongs that we are used to seeing, but instead high-flow oxygen generates concentrations of almost 100% oxygen, corticosteroids, and an autonomous recovery of the respiratory system. Treatment is mainly based on corticosteroids.
Recovery can be almost complete, depending on the patient’s previous situation, but there are people who develop a certain degree of pulmonary fibrosis and decreased respiratory function, and in some cases require a lung transplant.
Dr. Allan Sam concludes that “the use of vapers is strongly discouraged as a substitute for tobacco and is not considered an intermediate step in quitting smoking, rather the opposite, a gateway to vaping products – with nicotine , or not-. They are not a solution because any form of smoke or vapor inhalation carries a risk, which may be oncological or non-oncological, which especially affects people with respiratory system diseases such as asthma, or pregnant women, because they are also It has shown that babies can be born with less weight, or with neurological alterations”.
.