Vaping Related Lung Injuries on the Rise in PH

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It started with this tweet I passed by on my social media rounds sharing a case report about a 22-year old male without any known preexisting medical conditions dying of acute lung injury and heart attack. A risk factor identified was the 2 year history of vaping.

https://twitter.com/DrMeredithGT/status/1793159001129292054

Since it's a case report, you'll be able to see the documentation about this provided within the tweet's link. He developed vaping‐use associated lung injury (EVALI), which is a lung condition that is caused by the chemicals from vape.


I'm not going to bombard this post with medical jargons and keep it as a simple trivia. The heated vapors from vape irritate the airways and depresses the natural protection barriers of the body similar to how tobacco products work but this time it's less potent than tobacco products (as advertised). Another mechanism is messing up with the body's surfactant production.

Surfactant is the stuff that makes it easy to do gas exchange between oxygen and carbon dioxide when breathing. It loosens the surface tension of water within the lungs and let's gas exchange happen with less effort. Water is produced in the lungs and surface tension is that property where water tends to stick together and form a resistance.

Think of your palms as oxygen then press in on a surface of water, under normal conditions, the resistance you feel is easily overcome and your palms just sink through, surfactant is the stuff that makes your palms push through the surface with less tension and less of it would feel like pressing against the wall.

That's one way to imagine how surfactant works on the lungs. A disruption to this regulation can be caused by killing the cells that produce the surfactant (type II pneumocytes) or hastening the process of eliminating it. Vape seems to do the former.

Anything in excess is poison that's why medicinal drugs have a therapeutic index where a normal range.


In 2019, the first case of EVALI was recorded after a 16-year-old girl who used a vape and a traditional cigarette at the same time felt severe shortness of breath.

In July 2022, the Republic Act No. 11900, The Vaporized Nicotine and Non-Nicotine Products Regulation Act was implemented which puts age restrictions for people who buy vape which should be above 18 years old.

However, the recent news as of March 2024 is that the Department of Health (DOH) supports banning of using disposable vapes due to its harmful effects not only to our health but also in the environment. There is still no updated news about the banning of vapes.

Overall, the continuous increase of EVALI cases reported in the country (Philippines) is alarming especially since there are currently seven EVALI cases nationwide where most of them are aging between 20-25 years old.

Why do people still consume what kills them? just my opinion and mine alone, but facts don't really change people even if everyone already knew that smoking tobacco is just slowly poisoning their bodies, it still feels good and addictive.

That's just part of human nature to be irrational and refraining doing the right thing despite knowing it's good for them. Vaping marketed as a safer alternative from the same companies that sell you tobacco is likely a survival attempt as a business. Vaping appeals more to the younger folks... because the older target customers are dying out.

Thanks for your time.



12 comments
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I'm quite firm in my belief it has all to do with the oils in the flavourings they use in the vapes causing something called a "Popcorn Lung". It's got an interesting history where those preparing popcorn get weird lung symptoms.

Oh... I wasn't the only-one to think of this, as they do indeed link "Popcorn Lung" to the flavourings in the e-cigs.

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When I read popcorn lung, the first thing I thought was the cannon ball popcorn like formations malignant tumors on the lung manifest during stage IV, totally unrelated to what you said but that's from word association habits back in med school. Nice follow up on the e-cigs, I think the actual number of cases will increase since there's a lag time between when symptoms manifest and patients seek consult just like how the case above had a history of years of exposure before being on a case report.

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I got rid of cigarettes with a vape. I stopped using the flavours pretty soon after I had tried them. (I had heard about the popcorn lung thing, and associated it with the oils used in the flavouring liquids.)

The way to ween off nicotine dependency is to cut the amount of nicotine in half each time you re-fill the fill-up bottle. After a while, all you get from the vape is water vapour without any nicotine. Soon you'll notice there's no real reason to use it anymore.

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The way to ween off nicotine dependency is to cut the amount of nicotine in half each time you re-fill the fill-up bottle.

This works if the person intending to use the vape wants to ween off from the substance. I think part of the misinformation is promoting it as a healthier alternative, it's still poison that one's body can live without but now less potent than regular tobacco smoking. I'd generally don't care what people do with their money or body but cases on the rise are from the younger people which are financially dependent on their folks to bail them out of their health care costs which and it's a death spiral to get hospitalized on a third world.

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Well, as a matter of fact, if you take out the flavorings, vaping is pretty much just water vapor and nicotine. Yes, nicotine is a drug, and it's a bad one, but it would be even worse misinformation to claim it is equally as bad as smoking cigarettes. Tobacco smoking includes all the harmful components of vaping, plus tar, carbon monoxide, and hundreds, if not thousands, of other carcinogenic substances.

Vaping can be promoted as a healthier alternative because it actually is.

I guess nobody really wants to get addicted to nicotine, but many already are. One surefire way to get out of that addiction is to wean off gradually. Even if you have trouble quitting entirely, vaping significantly reduces health risks compared to smoking.

If someone truly wants to quit or even just reduce their nicotine intake, vaping is a highly efficient method. Traditional methods lack the active component of smoking, which makes them less effective for some people. With vaping, it's much easier to manage the nicotine dosage and gradually reduce it without the "this is my last cigarette" dilemma. The ability to lower the nicotine concentration incrementally helps reduce cravings and makes it easier to avoid the next one or the "last one."

I understand your concern about younger people picking up vaping and the potential financial burden on their families. It's definitely troubling to see any form of substance use being glamorized or seen as "cool" by kids. As a parent myself, I share your worries about this trend.

My main point is that for current smokers, especially adults who have been smoking for a long time, vaping is a less harmful alternative. It offers a way to reduce or quit nicotine dependency without the severe health risks associated with smoking tobacco.

However, I believe it's crucial to differentiate between vaping as a smoking cessation tool for adults and the unintended consequence of it being picked up by young non-smokers. Education and proper regulation are key to ensuring that vaping is used responsibly. Parents, schools, and communities need to work together to inform young people about the risks of nicotine addiction and to discourage non-smokers from starting to vape in the first place.

Ultimately, while I think vaping is a valuable tool for smokers looking to quit, we should also address and mitigate the risk of it becoming a new problem for the younger generations.

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Vaping can be promoted as a healthier alternative because it actually is.

Yes, I would prefer people vaping than tobacco smoking but if they can be left without both, that's even better. I think to quit smoking entirely and starting with transitioning to vaping with the initial intention to quit nicotine is a defining point. I see we're both agreeing to the same points about vaping is a good tool to quit tobacco smoking and even quitting. On the other hand vaping is someone else's introduction to nicotine and possibly transitioning to tobacco smoking as seen from the younger generation picking up. But it's not wise to generalize that vaping habits lead to tobacco smoking at this point.

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I used to try vaping when I was in high school. When vaping wasn't yet banned at a young age, for me, they preferred using a vape because the smoke was not so bad; it's not like a cigaritte, and the aroma had a flavor too, which is also addictive. But I feel that while I smoke the vape, I can also taste the taste of rust because, of course, the vapes are battery-operated too. That's why I didn't continue vaping before because I felt it would damage my lungs faster than cigarettes.

Vaping appeals more to the younger folks... because the older target customers are dying out.

I think not at all. because I don't seem to see any older people of that age vaping. They still prefer smoking tobacco cigars. Vaping among young people today is popular because they think it's cool. I see a lot of young women vaping too, keeping up with the trend just to please a lot of people. Because other young people think vaping and videos of blowing smoke from vaping make them look cool. 🤷🏼‍♀️

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I don't vape or smoke but not my body to care if someone else indulges in the habit. I tend to be more harsh if the younger folks do it if they're not financially established to cater to their own future medical expenses once the chronic injury to their lungs catches up. It's a phase or a trend and let people pay their tuition sometime in the future.

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It makes me annoyed seeing young ones vape or smoke that in the first place, the money that they used to buy was the hard-earned money of their parents. But, what can we do? When that's their environment.

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I would only focus on things I can control. Everyone has their due date to feel the consequences of their actions and maybe it's unfortunate but everyone has a tuition to pay while living.

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