For those who vape, it’s never a bad time to quit. What better time, though, than during a global pandemic that, for the most seriously ill, involves a viral attack on the lungs?
The connection between vaping and the coronavirus remains unclear. For that matter, even smoking – a habit which steals, on average, a decade or more of a smoker’s life and kills 480,000 people in the United States every year (scary facts here) – may not be a major risk factor for serious cases of COVID-19, as a Chinese study has concluded.
The most recent data from the U.S. Centers for Disease Control and Prevention seem to back that up. They show that being a smoker or former smoker is a COVID-19 risk factor, but a far lesser risk factor for ending up hospitalized than is cardiovascular disease or chronic lung disease, for example. Of course, cardiovascular disease and chronic lung disease themselves are long-proven consequences of smoking.
Still, even if medical science is chasing the COVID-19 epidemic, lung specialists are united in their recommendation that vaping – be it nicotine or cannabis – is a risky proposition. Dr. Jeff Sippel, a pulmonologist in UCHealth’s Comprehensive Lung and Breathing Program who see patients for lung and respiratory conditions, doesn’t mince words.
“Anything that causes lung inflammation is going to be really bad in a setting of coronavirus,” he said. “That’s because you’re increasing the ability of the virus to stick to the lungs and get into the body.”
Slowing the escalator
That viral stickiness comes from injury that smoking and vaping can cause. In particular, smoking and vaping damage what’s called the mucociliary escalator, a combination of cells that secrete mucous and then then usher foreign particles, bacteria, and, yes, viruses out of the lungs, Sippel says.
“Some of our protective mechanism are dead due to those sorts of injuries,” he said.
Sippel’s view prevails among lung specialists. But, one might ask, isn’t vaping a safer alternative to smoking? Tobacco vaping has long been touted as just that by those selling billions of dollars’ worth of cartridges, e-liquids, and hardware to cook the liquids into aerosols for inhalation.
No, the American Heart Association says.
“E-cigarette promoters claim the devices can help people quit smoking. But much more evidence is needed to determine if they are an effective way to quit,” association officials said. “Research suggest that users are more likely to continue smoking along with vaping, which is referred to as ‘dual use.’”
The American Lung Association has counted 600 ingredients in cigarettes that give off more than 7,000 chemicals once they’re lit. Among those chemicals include benzene (found in rubber cement and gasoline), cadmium (active component in many rechargeable batteries), and formaldehyde (the embalming fluid).
The contents of vaping e-liquids, being the new kids on the drug-delivery block, have been studied less. The U.S. Food and Drug Administration has issued no product standards, so ingredients can vary wildly – a worry in itself. E-liquids may have fewer chemicals, and because one isn’t combusting the product, there is no tar residue– the stuff from partially-burned plant materials that blackens a smoker’s lung.
But e-liquids have been found to contain some of the same chemicals of concern – benzene, cadmium, and formaldehyde among them. Perhaps the FDA’s January 2020 ban of most flavored cartridges is already shrinking the smorgasbord of substances being inhaled by vapers, too.
E-liquids aren’t benign
That does little to quell concerns about the impact of the thick liquids – solvents – in which nicotine, cannabis, and flavorings are dissolved. Solvents comprise the vast bulk of material being vaporized in a given puff. Propylene glycol, a form of alcohol, and vegetable glycerin, which is derived from plant-based oils, are two common solvents. Another solvent, vitamin E acetate, was behind more than 2,800 serious lung illnesses and 68 deaths from vaping that peaked in the fall of 2019.
Cases related to vitamin E acetate have largely disappeared with its use as an e-liquid solvent, Sippel says. But while propylene glycol and vegetable glycerin are safe to eat, no one knows if they’re safe to inhale with regularity.
“You’re basically inhaling really small oil droplets into your lungs, Sippel says. “Lungs are not meant to have oil in them. They’re meant to have salt water and air in them.”
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The nature of these solvents probably adds to the problem, Sippel says. They’re often thick and viscous, more like molasses than olive oil. Being completely foreign to the lungs, these solvents and other chemicals “are going to cause inflammation,” Sippel says.
Lung inflammation being a hallmark of serious cases of COVID-19, minimizing inflammation caused by vaping would seem the rational course right now, he adds.
If COVID-19 isn’t enough of a motivator, consider the costs, the youth vaping epidemic, and the health problems associated with nicotine itself. While medical marijuana is now legal in 33 states, cannabis has its own health impacts and may affect long-term brain development, which continues until about age 25.
It’s always a good time to quit vaping. Now is a great time to quit.
“It’s not a knowledge deficit. It’s a motivational deficit, a drug-addiction-driven deficit,” Sippel said. “Maybe COVID-19 will provide that motivation.”