Scans published by scientists have shown the lung damage caused by vaping in teenagers as young as 13.
Fourteen teenagers who were hospitalised with shortness of breath, coughing and chest pains were assessed by researchers.
They found fluid or debris filled sacs in the lungs, thickening and inflammation of tissue and pressure on the chest wall.
Doctors said the findings could help lead to early diagnoses of EVALI, which stands for e-cigarette or vaping product use-associated lung injury.
An outbreak of the recently discovered illness has so far caused 68 deaths among 2,807 cases in the US. Under 18s make up 15 per cent of patients.
Not much is known about the potentially deadly condition which emerged alongside the use of e-cigarettes. The oils and juices inside vapes are thought to stick inside the lungs, causing a build-up of material that is visible in chest scans.
Scientists have published scans showing the lung damage caused by vaping in teenagers who became ill with EVALI. Pictured, a scan from a 16-year-old boy with a two-year history of vaping shows air spaces in the lungs filled with a substance, usually pus, blood, or water
Pictured, the scan of a 16-year-old girl who had been vaping for one year. She had air spaces in the lungs filled with a substance, surrounded by thickened and inflamed soft tissue, known as a ‘reversed halo’. Some 36 per cent of the patients had this
First introduced in the US around 2007, e-cigarettes are now the most used tobacco product among youth in the US, often marketed as a safer alternative to regular cigarettes.
More than 3.6million middle and high school students were using e-cigarettes in 2018, according to the National Youth Tobacco Survey.
Researchers from UT Southwestern Medical Centre in Dallas used both chest X-ray and CT imaging to examine the effects of vaping in seven boys and seven girls, ranging in age from 13 to 18-years-old.
‘This population is particularly vulnerable to e-cigarette use and its potentially life-threatening consequences,’ said the study’s lead author, Dr Maddy Artunduaga, an assistant professor of paediatric radiology at UT Southwestern Medical Center.
All patients had respiratory symptoms, such as chest pain and shortness of breath.
Twelve patients also had gastrointestinal symptoms, such as vomiting, nausea, diarrhoea or abdominal pain. Other symptoms included fever, chills, weight loss and fatigue.
The youngsters all used an e-cigarette or engaged in dabbing – the practice of inhaling small quantities of a concentrated and vaporised drug, such as cannabis oil – in the 90 days before they started showing EVALI symptoms.
Four patients had a history of using both THC and nicotine-containing vaping products while nine had used THC-containing vaping products only.
One patient used nicotine-containing vaping products only.
Patients mainly showed air spaces in their lungs filled with a substance, usually pus, blood, or water, known as ground-glass opacity.
Ground-glass opacity is frequently associated with consolidation, which is thickening or swelling of soft tissue. Consolidation is a symptom pneumonia and can also cause pulmonary infections and breathing problems.
Subpleural sparing, pressure on the chest wall, was seen in 79 per cent of patients. It is also seen in a rare pneumonia disorder that affects the tissue that surrounds and separates the tiny air sacs of the lungs.
The scan of a 17-year-old boy showed a build-up of material or fluid, surrounded by hardened tissue. The patient had suffered eight days of vomiting and fever
Some 36 per cent of the patients had what is known as ‘the reversed halo sign’. This is when fluid-filled sacs are surrounded by a complete ring of inflamed tissue, about two millimetres thick.
Dr Artunduaga said chest X-rays and CT scans together ‘can lead to the early diagnosis of EVALI, which would ultimately allow the timely management of this entity in the paediatric population.’
A recent study suggested that the number of US teenagers who begin vaping at age 14 or younger has tripled in the last five years.
Researchers found that 28 percent of e-cigarette users in 2018 said they started vaping no later than 14-years-old.
That’s more than a three-fold spike from the nine percent who reported the same thing in 2014.
The team, from the University of Michigan School of Nursing, said the findings were worrying and that health campaigns targeted towards pre-teens explaining the dangers of vaping are urgently needed to reverse the trend.
The Centers for Disease Control and Prevention has identified vitamin E, an additive in some THC-containing e-cigarette, or vaping, products, is strongly linked to the EVALI outbreak.
They tested lung fluid samples from ‘geographically diverse states’ in the US, finding the vitamin ever present in people suffering from EVALI.
However, scientists said that the vitamin is probably not the only component in vapes that can make people ill, stressing that their investigation is ongoing.
Dr Scott Aberegg, a critical care pulmonologist at University of Utah Health echoed concerns of doctors in the US when he said: ‘It may turn out there are only two kinds of people who get this disease: those who vape THC and those who won’t admit it.’
He was suggesting that EVALI is directly linked to THC vaping and those that have it and say they only vape nicotine aren’t being completely honest.
The UK has not seen an outbreak in vaping illness. Vitamin-E acetate is banned in nicotine e-cigarettes in the UK, along with a range of other ingredients.
However, there have been 20 reports of serious adverse reactions to vaping and two potential deaths, according to the Medicines and Healthcare products Regulatory Agency.
Public Health England insists vaping is 95 per cent safer than using cigarettes. It has soared in popularity in the UK — there were only 700,000 people vaping in 2012 compared to 3.6million today.
