- They explain that patients inhale an aerosol that contains the same substances as conventional tobacco along with flavorings, which make the product more attractive, but also increase irritation of the lungs and respiratory tract and are addictive.
- A new disease, known as Evali, has been defined, directly related to the use of vapers, which contain vitamin E oil, and which presents with bilateral pulmonary infiltrates and can lead to respiratory failure.
Valencia, August 22, 2023 – Summer, holidays and free time increase the occasions in which young people, and not so young, meet and meet in festive and leisure environments in which, more and more, elements such as electronic cigarettes and water pipes or hookahs, which have already set off alarm bells in the Pneumology services of the group's hospitals Ribera for associated health problems. "Lipoid pneumonias have been described due to the consumption of electronic cigarettes, a new disease known as Evali, directly related to vapers, and bronchiolitis obliterans, related to flavorings such as diacetyl", as explained by the head of the Pneumology Service of the Torrejón University Hospital, Soledad Alonso.
Ivis Suárez Lorenzo, head of the Smoking Cessation Unit of the Vinalopó University Hospital, explains the similarities and differences between the electronic cigarette and the water pipe, also known as cachimba, sisha, argille or hooka. “The electronic cigarette is made up of a cartridge that contains the e-liquid and that, after its heating activated with the aspiration, it releases the aerosol or vapor; while the operation of the water pipe is similar to that of a tobacco cooking machine that, when sucked through a hose, causes a piece of incandescent coal placed on top to heat the tobacco, mixed with molasses and flavorings, generating the aerosol that is inhaled”, he assures. This, as Dr. Suárez points out, "contains very high levels of carbon monoxide, from the combustion of coal, hundreds of known toxins and dozens of human carcinogens, such as nicotine."
In both cases, Dr. Alonso highlights the harmfulness of its consumption, since "inhaling an aerosol of small particles, where we not only find the same substances as in conventional tobacco, but also flavorings, propylene glycol and glycerin, which increase irritation lung and respiratory tract" and that has already been shown to be the cause of pneumonia, bronchiolitis and other respiratory diseases. “The number of chemicals found in these devices is innumerable, many the same as those in conventional tobacco, but others that are novel and just as harmful,” she asserts. She is also very critical of the use of flavorings in these devices because "they are more attractive to the young population and it is not taken into account, for example, that most of these flavorings contain diacetyl, which has been linked to bronchiolitis obliterans." ”. All this, she adds, without counting other milder symptoms already described such as nausea, vomiting, diarrhea and fatigue.
Specifically regarding electronic cigarettes, Dr. Suárez warns of short-term problems such as coughing and local irritation, but recalls that a new lung lesion associated with the use of these devices has already been described, called Evali, and that it has been linked with vitamin E acetate. Also, remember that the e-liquid of the cartridge "may contain nicotine, extracted from tobacco with different degrees of purity, propylene glycol, vegetable glycerin and hundreds of flavorings, sachets with a sweet, menthol and fruit flavor, which are the ones that most alter DNA, as well as other substances generally in concentrations low". “Among the substances that reach the respiratory tract are acetaldehydes, formaldehydes, acrolein, carbonyls or even benzenes, already recognized as human carcinogens,” he adds. In case there is any doubt.
Regarding hookahs, the person in charge of the Vinalopó Smoking Cessation Unit warns that "addiction to nicotine administered with a water pipe can be very intense" and points out as acute effects of consumption an increase in respiratory rate, the reduction of flows spirometry and a reduction in peak-flow, or dyspnea, measured on the Borg scale. “The long-term effects are not yet clearly established, as it is an emerging phenomenon, but an association with polycythemia, which is a rare and serious blood disease that causes the bone marrow to produce too many blood cells, has already been shown. red cells to circulate in the bloodstream, lung cancer or chronic obstructive pulmonary disease”, he explains.
Dr. Alonso recalls, for her part, that "the use of hookahs is still a vaping system, where not only the substances that are consumed come into debate, but also the importance of cleaning the systems and the mouthpieces that are used".
Both specialists also warn about the addiction generated by these devices, whether they contain nicotine or not. “By making them more attractive to young people, they can generate a psychological and gestural dependence on it, as well as favor the consumption of other inhaled substances, such as cannabis. It is a way to start consumption, ”they say.
