What is EVALI (e-cigarette or e-cigarette-associated lung injury)?

Reviewed by Dr. Michael Kessler, DC— Just before the COVID-19 pandemic shook the world, a smaller, more localized pandemic was taking shape. EVALI, or e-cigarette or vaping-associated lung injury, has been affecting a young, healthy population.

It may seem that vaping and COVID-19 are unrelated, but EVALI, caused by e-cigarettes, may make users more vulnerable to the virus and its severe symptoms.

EVALI was identified in the fall of 2019, when an uncommon lung-related illness caused large numbers of patients to be hospitalized. It was quickly identified as a vaping-related lung disease, likely caused by vitamin E acetate, an additive in THC (tetrahydrocannabinol) vape products.

THC is the psychoactive compound found in marijuana that makes people “high.” THC on its own will not cause EVALI.

The connection to Covid-19 is that both conditions affect the respiratory system, while the process of vaping can pose an additional risk to users.

What is EVALI?

EVALI is an acronym for “e-cigarette or vaping-associated lung injury,” a term that was coined in late 2019 to replace VAPI, or vaping-associated pulmonary injury. The new name was in response to the significant rise in lung cases associated with vaping.

Like a lot Covid-19Researchers are still learning a lot about the disease, what exactly causes it, how to treat it, and what the mechanisms are behind it. But they identified a very strong relationship in a study of lung disease caused by vaping with THC.

Symptoms of EVALI include:

• shortness of breath
• difficulty breathing
• Chest pain
• Gastrointestinal diseases

The reason for the increase in cases is likely related to increased use among young people. In 2012, the number of middle and high school students using e-cigarettes was less than three percent. These numbers have since risen to more than 20%.

Causes of EVALI

Vaping is often viewed as a safe alternative to smoking. But although it is an obvious alternative, it is by no means one security. Doctors have long warned people about the safety of vaping, stating that the practice is too new to understand. The picture is now clearer.

E-cigarettes do not produce smoke. What is important about these devices, apart from addiction, is the components and interactions that may occur when they are heated and introduced into the lungs. It is important to know how it works:

First, the sensor heats a small amount of liquid with each puff of the e-cigarette. The liquid then turns into vapor which is inhaled. This vapor is then absorbed into the bloodstream, and the remaining aerosol (steam) is exhaled.

The liquid is usually flavored, and contains either nicotine, like a tobacco cigarette, or tetrahydrocannabinol (THC), like a marijuana cigarette.

Vaping can cause serious damage to your lungs. These products contain chemicals and molecules associated with conditions such as:

• Lung disease
• asthma
• Pneumonia
• Chronic obstructive pulmonary disease (COPD)
• Lung damage
• My heart disease
• Popcorn lung (bronchiolitis obliterans)
• Lipoid pneumonia (fat enters the lungs)
• Collapsed lung

Officials believe EVALI is caused by vitamin E acetate found in vape products containing tetrahydrocannabinol (THC).

Vitamin E acetate is an oil used to thicken or dilute e-cigarette liquids, specifically to thicken the tetrahydrocannabinol (THC) in e-cigarettes. However, it can be found in tobacco products, although to a much lesser extent.

The CDC report compared lung fluid in healthy people and those with EVALI. Vitamin E acetate was not found in any of the healthy samples, whereas it was present in 48 of the 51 EVALI participants.

Here are some fast facts about EVALI and Vitamin E Acetate:

• Scientists have found it difficult to pinpoint the exact cause because brands of products and their ingredients vary.
• “Dank Vapes,” a product containing THC, are commonly associated with EVALI.
• Exclusive use of THC vape products increases vapers’ risk of developing EVALI.
• Vitamin E acetate is closely associated with EVALI. As a topical or dietary supplement, vitamin E is safe.
• Vitamin E acetate is a petroleum derivative used as a thickening agent in e-cigarette products, and about half of the products linked to EVALI.
• Other chemical ingredients that may trigger EVALI include:
  • Triglycerides
  • Vegetable oils
  • Petroleum distillates
  • Diluted terpenes

Tetrahydrocannabinol (THC) and vitamin E acetate

As mentioned earlier, THC and other forms of vitamin E are not dangerous in and of themselves. But when vitamin E acetate is added to the oil agent as a thickener for vape products, it creates a dangerous situation.

Vitamin E acetate is quite sticky, and there is evidence to suggest that it may stick to lung tissue and remain there. It is not yet clear for how long. Identifying Vitamin E Acetate in relation to THC products is fairly simple: THC is known to leave the lungs very quickly, yet it remains when Vitamin E Acetate is present.

Of course, not every case of EVALI is associated with vitamin E acetate, but a remarkably high percentage of cases are.

Some research suggests that vitamin E acetate leaves a layer of oil over the membranes in the lungs that is essential for their stability and expansion, ultimately impairing the breathing process.

One study found that tetrahydrocannabinol (THC) was present in 82% of samples from EVALI patients. Sure enough it was kept there by the vitamin E acetate.

EVALI and COVID-19

Research suggests that vaping and COVID-19 have a close relationship, and EVALI likely makes COVID-19 much more dangerous.

Vaping may be associated with a five- to seven-fold increased risk of contracting COVID-19 among teens and young adults in the United States.

Vaping may increase the risk of contracting COVID-19 because it requires significant hand, face, and mouth contact. One of the biggest preventative measures against coronavirus (COVID-19) is keeping hands away from the face.

EVALI may also affect the outcome of COVID-19 infection. If your lungs are already fighting lung disease caused by vaping, adding another condition that attacks your respiratory system could lead to a dangerous situation.

Tips to quit vaping

Quitting vaping can be very difficult. People often struggle to quit smoking because e-cigarettes have fun, candy-like flavors, provide high doses of addictive nicotine or tetrahydrocannabinol (THC), and are easy to use and quickly become habit-forming.

One of the most important, but often overlooked, aspects of quitting smoking is planning. When you have an idea of ​​how to quit vaping, you can create a targeted plan of attack. Here are some tips to help you create your plan:

• Find out why you’re retiring: When you have a reason to quit, it’s easier to stay consistent when temptation hits.
• Do not provide opportunities to cheat: Avoid all tobacco-related products or e-cigarettes. Alternatives will throw you out of your way.
• commits: Give yourself time to prepare, and get started within a short period of time.
• Learn your triggers: It’s important to know your triggers so you can avoid them.
• Prepare for cravings and withdrawals: It will happen, so you have to learn how not to give up. Sometimes, going out for a walk, eating an apple, or distracting yourself with work or another activity can help you get over cravings.
• Imagine yourself without vape: Think of the old saying, “If you can imagine it, you can do it.” Focus on your goal and take the necessary steps to achieve it.
• Have a support system: Friends, parents, or professionals can be part of your team to help you quit e-cigarettes and vaping.

Vaping is no safer than smoking

Vaping is trendy, and for some, it tastes great. But it is not a healthy alternative to smoking. It comes with its own set of risks, some of which seem to start very quickly. Ingredients, such as vitamin E acetate, are potentially very dangerous and should be avoided to reduce the risk of EVALI, especially amid the COVID-19 pandemic.