Understanding EVALI: Vaping-Related Lung Illness

by Rosabel Zohfeld, APRN, MSN-Ed, FNP-C

EVALI, short for e-cigarette or vaping product use-associated lung injury, is a relatively new and concerning health issue that has emerged in recent years. It has garnered significant attention from public health authorities, medical professionals, and the general public due to the severity and sudden onset of the illness. 

Inhaling vapor that is produced by electronic cigarettes or other similar devices is known as vaping. Vaping has gained popularity over the past decade. The vaping devices work by heating liquid nicotine, flavorings, and other chemicals in an aerosol form that users inhale. Vape devices were initially marketed as a safer alternative to traditional tobacco smoking, with many believing it could help people quit smoking altogether. However, concerns have grown regarding the safety of e-cigarettes.

EVALI first came to the attention of public health officials in the United States in the summer of 2019 when a series of cases involving severe lung injury were reported across the country. Many patients presented with symptoms such as cough, chest pain, shortness of breath, and fever. As the number of cases continued to rise, it became clear that EVALI was a severe public health concern.

Research and investigations into EVALI have revealed that the illness is primarily associated with the use of vaping products containing tetrahydrocannabinol (THC), the psychoactive compound found in marijuana. The exact cause of EVALI remains complex and multifactorial, but several factors have been identified:

1. Contaminants and Toxins: Many cases of EVALI have been linked to vaping products contaminated with harmful substances, including vitamin E acetate, which is used as a thickening agent in some vape oils.
2. Chemical Exposure: The inhalation of various chemicals, including diacetyl, formaldehyde, and acetaldehyde, found in some e-cigarettes, may contribute to lung damage over time.
3. Black Market Products: Some EVALI cases have been associated with the use of illicit or black-market vaping products, which may contain unknown and potentially harmful ingredients.

The symptoms of EVALI can range in severity, and they often mimic those of typical respiratory illnesses. Common symptoms include:

1. Cough
2. Shortness of breath
3. Chest pain
4. Fever
5. Nausea
6. Vomiting
7. Diarrhea

In severe cases, EVALI can lead to respiratory failure and, in some instances, death. It is crucial for individuals who experience these symptoms, especially if they have a history of vaping, to seek immediate medical attention.

The treatment of EVALI largely depends on the severity of the illness. Mild cases may require only supportive care, such as rest and hydration, while more severe cases may necessitate hospitalization and oxygen therapy. Quitting vaping is a crucial step in recovery for those diagnosed with EVALI.

Preventing EVALI starts with avoiding the use of e-cigarettes and vaping products, especially those obtained from unregulated sources. For individuals who are already vaping or considering it, here are some preventive measures:

1. Choose Trusted Products: If you choose to vape, use products from reputable manufacturers and retailers. Avoid black-market or homemade vape liquids.
2. Educate Yourself: Understand the potential risks associated with vaping and be aware of the symptoms of EVALI.
3. Don't Modify Products: Avoid modifying or tampering with vaping devices, as this can increase the risk of exposure to harmful chemicals.
4. Seek Support to Quit: If you are currently using vaping products, seek help and support to quit. Many resources are available to assist individuals in overcoming nicotine addiction. For those who are now vaping, EVALI serves as a compelling reason to stop vaping. Many resources are available to help individuals overcome nicotine addiction, and healthcare professionals can offer guidance and support to those who seek to quit.

As the vaping industry continues to evolve, so does our understanding of the potential health risks associated with these products. EVALI has quickly become a severe public health concern, raising essential questions about the safety of vaping and the need for better regulation in the industry.

EVALI is a stark reminder that the vaping industry and public health are inextricably linked. The rise of vaping-related lung injuries demands immediate attention from all stakeholders involved. Manufacturers, regulators, healthcare professionals, and the public all have roles to play in addressing this crisis. By promoting education, accountability, and regulations, we can work to reduce the risks associated with vaping and protect the well-being of individuals in our communities. EVALI serves as a wake-up call for us all, and it's high time we heed its warning.