Is There a Link Between Vaping and COVID-19?

vaping devices or electronic cigarette

E-Cigarette Users Face Increased Risks from Coronavirus

As the coronavirus takes a terrible toll on the country, certain populations are experiencing worse outcomes than others. Seniors, for example, are a susceptible population and have higher fatality risks once the disease is contracted, as are adults with underlying health conditions, including diabetes, heart disease, and immune deficiencies. While it was initially believed that young people might avoid severe respiratory disease from exposure to COVID-19, that, sadly, has not been the case in recent weeks. Now, another vulnerable population has been identified:  vapers. 

Recent studies show that vaping significantly suppresses the immune system and inflames the lungs, making it easier for the coronavirus to progress. Named for the microscopic spikes that cover its surface, the virus digs into and attacks the respiratory tract of patient, differentiating it from the seasonal flu.

“Reporting of respiratory symptoms by e-cigarette users suggests increased susceptibility to and/ r delayed recovery from respiratory infections,” according to an article by the University of California San Francisco’s Center for Tobacco Control Research and Education titled “Reduce your risk of serious lung disease caused by corona virus by quitting smoking and vaping.” “A study of 30 healthy non-smokers exposed to e-cigarette aerosols found decreased cough sensitivity. If human ciliary dysfunction is also negatively affected, as suggested by animal and cellular studies, the combination of reduced coughing and impaired mucociliary clearance may predispose users to increased rates of pneumonia. Exposure to e-cigarettes may also broadly suppress important capacities of the innate immune system. Nasal scrape biopsies from non-smokers, smokers, and vapers showed extensive immunosuppression at the gene level with e-cigarette use.”  This medical publication reiterates the general COVID-19 protection guidelines laid out by the Centers for Disease Control and Prevention (CDC), the U.S. Food & Drug Administration (FDA) and state and local health departments about handwashing and social distancing, but also includes the recommendation that patients stop vaping and use of e-cigarettes.

“CDC, FDA, the Surgeon General, state health departments and everyone (including comedians, such as John Oliver who spent his whole show on the issue last weekend) working to educate the public on how to lower risk of serious complications from COVID-19 should add stopping smoking, vaping, and avoiding secondhand exposure to their list of important preventive measures,” the article states. “This would also be a good time for cities, states private employers and even individual families to strengthen their smokefree laws and policies – including e-cigarettes – to protect nonsmokers from the effects of secondhand smoke and aerosol on their lungs and to create an environment that will help smokers quit.”

EVALI – New Vaping-Related Disease

The CDC already has seen an increase in pulmonary disorders related to vaping, classifying this characteristic condition as EVALI, an acronym for “e-cigarette, or vaping, product use associated lung injury.”

“EVALI is the name given by the Centers for Disease Control and Prevention (CDC) to the dangerous, newly identified lung disease linked to vaping,” according to an article by Yale Medicine titled “E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI).” “The illness was first recognized by the CDC in August 2019 after health department officials across the country began to work together to study cases of severe, sometimes fatal, lung infections that arose suddenly in otherwise healthy individuals. The number of people who needed to be hospitalized after experiencing symptoms ranging from shortness of breath to fever quickly rose in many states around the U.S. As more details emerged, doctors and researchers discovered that patients shared at least one common risk: all reported they had recently used e-cigarette or vaping products.”

Symptoms of EVALI include shortness of breath and cough as well as chest pain and fever, which mirror the symptoms of the coronavirus and double the trouble.

“Health officials continue to investigate which ingredient(s) may be causing EVALI,” the Yale Medicine article states. The researchers at Yale have focused on the “high-inducing chemical derived from marijuana, called THC” as the culprit in vaping-induced lung disease, a factor also cited by the CDC.  Other researchers evaluating safety issues associated with vaping and e-cigarette and the mechanism by which they cause lung disease are also focused on the high levels of heat associated with vaping, use of nicotine salts, and the potential toxicity of flavorings used in e-cigarettes, including the wildly popular JUUL products often used by children.  Meanwhile, a study found that people who use only e-cigarettes increase their risk of developing lung disease by about 30% compared with nonusers.  The Yale researchers, who tracked young adult smokers and vapers over three years, noted an elevated risk of being diagnosed with lung disease – which includes chronic bronchitis, emphysema, asthma, or chronic obstructive pulmonary disease (COPD). 

Vaping danger and toxic air health risk

‘Especially Serious Threat’

The National Institute on Drug Abuse also weighed in about the effects of the coronavirus on vapers and other substance abusers/users, saying that vaping children and adults are at greater risk in the current pandemic. “As people across the U.S. and the rest of the world contend with coronavirus disease 2019 (COVID-19), the research community should be alert to the possibility that it could hit some populations with substance use disorders (SUDs) particularly hard,” the institute writes in a blog titled “COVID-19: Potential Implications for Individuals with Substance Use Disorders.” “Because it attacks the lungs, the coronavirus that causes COVID-19 could be an especially serious threat to those who smoke tobacco or marijuana or who vape. We know very little right now about COVID-19 and even less about its intersection with substance use disorders. But we can make educated guesses based on past experience that people with compromised health due to smoking or vaping and people with opioid, methamphetamine, cannabis, and other substance use disorders could find themselves at increased risk of COVID-19 and its more serious complications – for multiple physiological and social / environmental reasons. The research community should thus be alert to associations between COVID-19 case severity/mortality and substance use, smoking or vaping history, and smoking- or vaping-related lung disease.”

Epidemic Meets Pandemic

The FDA has banned sales of flavored e-cigarettes to curb vaping and has clamped down on the industry by further regulating manufacturers and vaping retailers. The agency describes the use of e-cigarettes by youths as a nationwide “epidemic.”

“The FDA stands ready to accelerate the review of e-cigarettes and other new tobacco products,”  In July of 2019 (when the coronavirus was not a reality), Dr. Norman Sharpless, commissioner of food and drugs, said in an FDA statement. “And we remain committed to tackling the epidemic of youth vaping using all available regulatory tools at our disposal. We will continue to take vigorous enforcement actions aimed at ensuring e-cigarettes and other tobacco products aren’t being marketed to, or sold to, kids. We will continue expanding our highly successful education efforts, such as “The Real Cost” campaign, to educate youth about the dangers of using tobacco products, including e-cigarettes. And we will continue to implement the policies to keep e-cigarettes and all tobacco products out of the hands of America’s kids.”

Because of an unprecedented viral outbreak at a time when vaping is at a peak, doctors are pleading even more aggressively for patients to quit, given the underlying risks associated with vaping and the enhanced risks to vaping patients with the coronavirus.

“As health officials continue to encourage, publicize, and even mandate measures to slow the spread of the novel coronavirus, doctors stress that unlike risk factors for which there is no cure – like diabetes, heart disease and older age – e-cigarette use is behavior that can be modified,” according to an ABC News article titled “Vaping and e-cigarettes: Adding fuel to the coronavirus fire?” “Doctors say the best time to stop smoking and vaping is now. Along with nicotine patches and gum, prescription medications can help curb cravings and fight addiction. For more information and resources, visit smokefree.gov.”