SHARES
As we mask up to fight against COVID-19, lung injury from vaping still lurks around the corner.
Dr Alvin Ng Choon Yong, Consultant Respiratory Physician and Intensivist with The Respiratory Practice at Farrer Park Hospital provides us with insights on the health risks of vaping.
Understanding Vaping
Vaping involves breathing in chemicals such as nicotine and flavors in aerosol form, which may hurt your lungs. Smoking cigarette delivers nicotine and other chemicals by burning solid tobacco. On the other hand, vaping does so through heated liquid with an e-cigarette or a vape pen.
Sales of e-vaporising products is illegal in several countries, including Singapore, Malaysia (and Thailand, where vaping is also illegal). These vape liquids are sold in cartridges or custom-made containers, using propylene glycol as the base to create vapor.
Some believe that vaping is a less harmful alternative to smoking, but Dr Ng advised otherwise.
“There’s still nicotine in the vaping products and therefore they remain addictive. Furthermore, the additives in these products may contain unknown substances. Hence, vaping may cause lung injury and death.”
The medical field categorizes these injuries as e-cigarette or vaping product use-associated lung injury (EVALI), making it a major health concern.
Grave Facts about Vaping
According to Dr Ng, e-cigarettes and related devices carry dangerous chemical cocktails containing acrolein and formaldehyde, commonly found in insecticides, car exhaust, or even embalming fluid used to preserve dead bodies. They are toxic to the lungs and are capable of triggering an inflammatory response, which can damage the narrow passageways in the lungs.
The injury sustained can be acute or chronic when built up over a long period, with symptoms similar to pneumonia. These patients may suffer from shortness of breath, chest pain and hacking dry cough.
EVALI does not respond to antibiotics and may lead to morbidity and mortality.
Other respiratory conditions associated with vaping:
- Vaping-related lipoid pneumonia (caused by inhaling the oily substances in the vaping liquid)
- Bronchiolitis obliterans a.k.a popcorn lung (where the small airways in the lungs are damaged by a flavour enhancer called diacetyl found in vaping liquid, leading to permanent scarring in the tiny branches of the lungs)
Treating EVALI
“Treatment is largely supportive with supplementary oxygen. If it worsens, the patient may require admission to the intensive care unit for special care with high-flow oxygen, non-invasive ventilation or intubation with mechanical ventilation,” said Dr Ng.
He also noted several case reports where severe lung injury improved with the use of steroid treatment.
As EVALI is a new condition, much research is still needed, and the prognosis remains unclear and unpredictable. In addition, the lack of long-term studies means that doctors are still unable to ascertain if one treatment is more effective than the other. As of February 2020, 2,807 EVALI cases or deaths were reported in the United States, although there are no vaping-related death reports in Singapore or Malaysia.
Adverse Health Effects of Vaping
Even if smokers have been vaping for years without apparent signs or symptoms, it does not mean that they should continue to smoke, as the damages caused can accumulate over the years. These damages, along with the release of free radicals into the body, can potentially result in cancer. Since vaping devices are still relatively new, the long-term outcomes of vaping remain unknown.
A research by the University of Birmingham suggested that vaping may weaken the immune system by “damaging vital immune system cells”, rendering smokers more vulnerable to other diseases. It may also impact brain development among children and teenagers, further reinforcing the case against it as a safer alternative to smoking for youngsters.
A Growing Concern among Youths
Attractive flavors, like bubblegum and cotton candy, has allowed vaping to gain popularity among youths. Peer influence and perceived trendiness also encourage youngsters to attempt vaping, and sadly, it eventually becomes a hard-to-kick habit.
Newspapers have reported that vaping continues to grow steadily as a trend in Singapore since 2018. The uptrend is also due to a lack of awareness among the youths in Singapore.
A Health Promotion Board (HPB) survey in 2018 that polled 600 youngsters revealed that seven in 10 did not know that e-cigarettes contain cancer-causing chemicals.
“Most vaping-related deaths in other countries involve young patients. It would be tragic if we start to see them among our youths,” cautioned Dr Ng.
In 2020, Australian National University’s researchers reviewed 25 existing studies. They reported that e-cigarettes users are three times more likely to smoke, which signals that vaping is potentially a gateway to smoking.
Vaping and COVID-19
The researchers at Stanford University School of Medicine found that youths who vape experience higher risk for COVID-19, and are five times more likely to experience breathing difficulty and coughing symptoms. Correspondingly, this is translated to higher hospitalization and mortality rates.
Given all these harmful effects and risks, it is clear that vaping shares similar risks as smoking. Therefore, quit vaping to steer clear of its detrimental effects to health.
Dr Alvin Ng Choon Yong, Consultant Respiratory Physician and Intensivist with The Respiratory Practice, contributed this article in collaboration with Farrer Park Hospital. Read the original article here.
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by Joanne Lee
Multipotentialite. Loves creating and seeing ideas come alive. View all articles by Joanne Lee.
