EVALI What is it? Acute Lung Injury from E-cigarettes
You may have heard that e-cigarettes (E-cigarette or Vaping) are a safer alternative to traditional cigarettes, but the truth is that e-cigarettes have brought a new severe lung health threat, which is EVALI disease.
EVALI stands for E-cigarette or Vaping product use-Associated Lung Injury, which means severe acute lung inflammation associated with the use of e-cigarettes or vaping products. It is a disease that requires urgent hospitalization, and in some cases, it can be severe enough to cause death.
Why do e-cigarettes cause EVALI?
Although the exact cause cannot be identified 100%, data from global investigations indicate that certain chemicals in e-cigarette liquids are the main factors causing inflammation and rapid lung tissue damage, especially:
- Vitamin E Acetate (วิตามินอีอะซิเตท) is a substance found to be the primary cause and is often used as a thickening agent, especially in e-liquids containing THC (cannabis extract). When this substance is heated and inhaled into the lungs, it directly damages the lungs.
- Other chemicals and heavy metals The vapor from e-cigarettes also contains ultrafine particles and heavy metals such as nickel, tin, and lead, which cause irritation and accumulated inflammation in the lungs.
Symptoms of EVALI
Symptoms usually occur suddenly and resemble respiratory infections but do not respond to antibiotics. Those who have a history of using e-cigarettes or vaping products within the past 90 days and have these symptoms should see a doctor immediately.
Respiratory symptoms
- Difficulty breathing/rapid breathing
- Severe cough (often dry cough)
- Chest pain
General and gastrointestinal symptoms
- Fever, chills
- Body aches
- Nausea, vomiting
- Abdominal pain, diarrhea
In severe cases, patients may experience oxygen deficiency (lung failure) requiring mechanical ventilation in the ICU, which can lead to death.
Diagnosis and treatment of EVALI
Diagnosis of EVALI is by exclusion. Doctors will take a detailed history of e-cigarette and vaping product use along with various examinations, including:
- Chest X-ray or CT Scan to detect diffuse white patches in the lungs.
- Blood oxygen level measurement often shows decreased oxygen levels.
- Blood/sputum tests to rule out infections from other viruses or bacteria.
Treatment of EVALI focuses on supportive care, generally using corticosteroids to reduce severe lung inflammation and supplemental oxygen to assist breathing.
The best way to prevent EVALI is “quitting e-cigarettes”
The misconception that e-cigarettes are safer than traditional cigarettes is dangerous because EVALI has proven that vaping can cause immediate severe lung damage. The best prevention is:
- Avoid using all types of e-cigarettes, especially among youth and those who have never smoked before.
- Do not modify or mix your own e-liquids and avoid using liquids of unknown or unregulated sources.
- Current users should quit completely. If you are trying to quit traditional cigarettes, consult a doctor or specialist for safe and medically approved methods.
EVALI (E-cigarette or Vaping product use-Associated Lung Injury) is a severe acute lung inflammation condition associated with e-cigarette use, which can rapidly worsen symptoms, requiring hospitalization, and in some cases, can be fatal. Although e-cigarettes are perceived as “safer,” in reality, they pose a new lung risk that should not be overlooked.
Diagnosis requires history taking combined with radiological examinations and exclusion of other diseases. Treatment focuses on supportive care such as oxygen therapy and anti-inflammatory drugs. Prompt treatment is crucial for survival chances.
Phyathai 2 Hospital recommends that the best prevention is to avoid or quit e-cigarettes completely and monitor for any abnormal respiratory symptoms. If symptoms occur, see a doctor promptly because awareness of risks and proper lung health care are key to preventing severe disease and maintaining long-term quality of life.
