SAFE GC Coalition: E-Cig or Vaping Use-Associated Lung Injury

According to the American Lung Association, EVALI stands for e-cigarette or vaping use-associated lung injury. It was originally known as VAPI (vaping associated pulmonary illness). The new name is in response to a growing number of severe lung illness cases related to using e-cigarette and vaping products, the first being identified in 2019. Health officials point to vitamin E acetate (an additive in some THC-containing e-cigarettes) as the primary, but not the only, cause of EVALI.

A Centers for Disease Control (CDC) report analyzed bronchoalveolar lavage (BAL) fluid from a larger number of EVALI patients from 16 states and compared them to BAL fluid from healthy people. They identified Vitamin E acetate, also found in product samples tested by the FDA and state laboratories, in BAL fluid from 48 of 51 EVALI patients, Vitamin E acetate was not found in any of the BAL fluids of healthy people. In addition to vitamin E acetate, there are many other substances and product sources in vaping materials that are being examined as possible causes.

There is no single test for EVALI. Diagnosis is mostly a process of elimination because symptoms can be similar to many other respiratory diseases. These include shortness of breath, fever and chills, cough, vomiting, diarrhea, headache, dizziness, rapid heart rate and chest pain. Your doctor will evaluate your history of e-cigarette use and other vaping devices, and may take a chest X-ray or CT scan to see if there are hazy spots on your lungs (called opacities) that indicate tissue damage.

Because the disease is relatively new, the course of the illness is unpredictable. Among the cases reported, 96% of patients required hospitalization, including some who died. Treatment is based on expert recommendations and depends on the severity of the illness. Primary medication treatments include antibiotics and/or antivirals until infection is ruled out as well as corticosteroids to help fight inflammation in the lungs. Patients with more severe cases will need hospitalization and, because they may be unable to breathe on their own, could be placed on a ventilator. Even patients who have less severe symptoms may need supplemental oxygen.

Once patients have regained the ability to breathe on their own, they may be allowed to go home. However, because researchers have found that some patients are relapsing and even dying soon after discharge from the hospital, doctors recommend that all patients regardless of severity schedule follow-up appointments with a pulmonologist within 48 hours after being discharged.

E-cigarettes only entered the market about a decade ago, and we are still learning the long-term effects. Researchers are working hard to learn as much as possible about the illness, its causes, and the most effective treatments.

The CDC recommends the following:

• Do not use THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online dealers.
• Vitamin E acetate should not be added to any e-cigarette, or vaping, products.
• People should not add any other substances not intended by the manufacturer to products, including products purchased through retail establishments.
• Adults using nicotine-containing e-cigarette, or vaping, products as an alternative to cigarettes should not go back to smoking; they should weigh all available information and consider using FDA approved cessation medications
• E-cigarette, or vaping, products (nicotine- or THC-containing) should never be used by youths, young adults, or women who are pregnant.
• Adults who do not currently use tobacco products should not start using e-cigarette, or vaping, products.
• THC use has been associated with a wide range of health effects, particularly with prolonged frequent use. The best way to avoid potentially harmful effects is to not use THC-containing e-cigarette, or vaping, products.
• Persons engaging in ongoing cannabis use that leads to significant impairment or distress should seek evidence-based treatment by a healthcare professional

To learn more about programs available to help tobacco users, including e-cigarettes and vaping products, to quit, contact the Lung HelpLine at 1-800-LUNG-USA.

SAFE, Inc. is the only alcohol and substance abuse prevention, intervention and education agency in the City of Glen Cove. Its Coalition is concerned about vaping and seeks to educate and update the community regarding its negative consequences. To learn more about the SAFE Glen Cove Coalition please follow us on www.facebook.com/safeglencovec... or visit the Vaping Facts and Myths Page of SAFE’s website to learn more about how vaping is detrimental to your health www.safeglencove.org.