Thanks to the emergence of the SARS-CoV-2 virus, the health of our lungs has been brought into focus. One consequence of the pandemic is that people are making drastic changes to improve lung health when they develop the respiratory disease COVID-19.
Because you can smoke cigarettes increase the risk of complications since COVID-19, people have quit smoking in record numbers in the past year. A recent poll from University College London shows that in the UK alone, more than 1 million people will quit smoking by 2020 – and a full 40 percent cited their concern about COVID-19.
When people decide to quit smoking, many will turn to vapes or e-cigarettes to get the nicotine fix they crave. Because these devices use the the same harmful chemicals present in cigarettes are often presented as a healthier alternative – but are they? Between cigarette smoking and electronic devices like vapes, which one is worse for health?
"The real answer is that it's too early for us to know if vaping is any less unhealthy than smoking," he says Renea Jablonski, a board-certified pulmonologist at the University of Chicago Medicine. While the long-term health consequences of smoking have been well documented (e.g., lung diseases caused by smoking kill more than 480,000 people annually) e-devices are relatively new and the effects of long-term use are unknown.
Lung injury from vaping
But the short-term consequences are becoming clearer. Last February, the U.S. Food and Drug Administration and health officials raised the alarm about an outbreak of lung injury related to vapes and e-devices, known as EVALI. (The name EVALI stands for lung injury from e-cigarette use or vaping.) In mid-February, the CDC reported more than 2,800 hospitalizations as a result of EVALI, along with 68 deaths across the country.
"The injuries we see (with e-devices) are usually acute and occur in patients who have only evaporated for a period of years – and often less than that," says Jablonski. In addition to EVALI, which is a lung injury specifically caused by the additive vitamin E acetate, Jablonski has seen numerous other types of lung problems from e-devices in her clinical practice. “I have taken care of patients in hospital who have had lung injuries to varying degrees from vaping, ranging from people who need small amounts of oxygen and are being treated with steroids to people who have been seriously ill in the ICU. about who we have considered transplantation as a possible option for their treatment. "
Surprisingly, Jablonski says, some patients with lung injuries from e-devices may show the same symptoms as patients with COVID-19. “Patients have come in with fever, shortness of breath and even gastrointestinal symptoms such as nausea or diarrhea,” she says. “We've had a number of patients who really looked like they had COVID, but who had tested negative several times. It's not until you step back and discover they have a history of vaping that you start putting it together. "
While it's commendable that cigarette users want to quit, Jablonski says, "we don't yet have the information to say with confidence that e-cigarettes are safer or even less harmful – the downsides could just be different." Instead, Jablonski suggests that users who want to quit smoking find a nicotine replacement therapy that works for them, such as pills, patches, or lozenges.
“There is a valid question as to whether (e-devices) might be less harmful than conventional cigarettes, but we just haven't had a chance to study that yet,” she says. “What we do know is that there are other treatments and drugs we can use to quit smoking that have a long track record of safety and efficacy, without the risks of e-devices. "