Can Vaping Lead to Lung Disease?

A recent string of hospitalizations among teenagers and young adults who vape has health officials concerned about the link between vaping and lung disease.

Man smoking an e-cigarette

Six people have died of a mysterious lung illness linked to e-cigarettes and approximately 380 people in 36 states have suffered vaping-related respiratory illnesses, including many teens and young adults who had to be hospitalized, according to the Centers for Disease Control and Prevention. State and federal health officials have issued warnings about the dangers of e-cigarettes in the wake of the hospitalizations, all of which have occurred in the last two months.

“While many people consider vaping to be a less dangerous alternative to smoking cigarettes, it is not risk-free,” New York State Health Commissioner Dr. Howard Zucker said in a statement, noting that the Health Department is actively investigating 11 cases of vaping-related lung-disease in New York State. “These latest reports of pulmonary disease in people using vaping products in New York and other states are proof that more study is needed on the long-term health effects of these products.”

More than 3.6 million young people in the United States use e-cigarettes, according to the Centers for Disease Control and Prevention, far more than the 280,000 estimated in 2011. The U.S. Surgeon General’s Office declared the situation a public health epidemic among youth, and, like the American Lung Association and other major organizations, has issued warnings about the dangers of e-cigarettes.

E-cigarettes are battery-operated devices with a heating element that turns liquid from a refillable cartridge into an aerosol that the user inhales. The aerosol is often filled with nicotine and other substances, and may contain flavorings and coloring. E-cigarettes are also known as vape pens, hookah pens, vaporizers and e-pipes. The American Lung Association says inhaling ingredients found in e-cigarettes may expose people to high levels of toxins, which can cause irreversible lung damage and lung diseases. Also, the nicotine found in many e-cigarettes is an addictive drug, just as it is in regular cigarettes, and can stunt the development of the adolescent brain and increase the risk for future drug addiction.

To better understand how vaping can affect your health, Health Matters spoke with Dr. Brendon Stiles, an associate attending cardiothoracic surgeon at NewYork-Presbyterian/Weill Cornell Medical Center and an associate professor of cardiothoracic surgery at Weill Cornell Medicine.

What do people need to know about the health risks of vaping?
We still have very little knowledge about the health consequences of vaping and e-cigarettes. However, a recent study shows precancerous changes in airway cells after e-cigarette use. Also, the New England Journal of Medicine recently published national estimates showing increased rates of vaping and nicotine use in adolescents.

What does vaping do to your lungs?
It still isn’t entirely clear. But what is clear is that e-cigarettes have been found to have chemicals and particles that have been linked experimentally to lung disease, including asthma and chronic obstructive pulmonary disease (COPD). Vaping can also cause lung inflammation, which has been linked to chronic lung disease as well.


“Dangerous chemicals found in e-cigarettes include acetaldehyde and formaldehyde, which have been associated with heart disease in addition to lung disease.”

— Dr. Brendon Stiles


Could it cause permanent lung damage? What about your heart?
It still isn’t known. However, teens may be most at risk for long-term effects since their lungs are still developing. Dangerous chemicals found in e-cigarettes include acetaldehyde and formaldehyde, which have been associated with heart disease in addition to lung disease .

Are there other health impacts of vaping?
There is certainly a real possibility that vaping could increase a person’s cancer risk. Studies have already shown that e-cigarettes can induce DNA damage and mutations in normal airway cells, which are precursor events to cancer. E-cigarette vapor may also adversely affect immune cells in the lung environment, leading to lung inflammation, another precursor to cancer.

Is there a secondhand impact?
Potentially, although this hasn’t been well studied.

Is there anything else you think is important for people to know?
The industry is poorly regulated and it is not entirely clear what is in different e-cigarette products, although harmful chemicals have been found in some. The recent hospitalizations are an unfortunate example of that. Certainly, this adds to the growing number of reports that vaping is not “harmless.”

Brendon Stiles, M.D., is an associate attending cardiothoracic surgeon at NewYork-Presbyterian/Weill Cornell Medical Center and an associate professor of cardiothoracic surgery at Weill Cornell Medicine. Dr. Stiles is an advocate for lung cancer patients and for cancer research in general. He is chair of the Lung Cancer Research Foundation’s Board of Directors. Dr. Stiles can be found on Twitter, @BrendonStilesMD, where he frequently comments on lung cancer, engaging directly with patients and advocacy groups.