The rise of electronic nicotine delivery systems and the emergence of electronic-cigarette-driven disease.

McAlinden, Kielan Darcy; Eapen, Mathew Suji; Lu, Wenying; Sharma, Pawan; Sohal, Sukhwinder Singh

In 2019, the United States of America experienced the emergence of the vaping associated lung injury (VALI) epidemic. Vaping is now known to result in the development and progression of severe lung disease in young and healthy. Lack of regulation on electronic cigarettes in the US has resulted in over 2,000 patients and 68 deaths. We examine the clinical representation of VALI and the delve into the scientific evidence of how deadly exposure to electronic cigarettes can be. E-cigarette vapour is shown to affect numerous cellular processes, cellular metabolism and cause DNA damage (implications with cancer). E-cigarette use is associated with a higher risk of developing crippling lung conditions such as COPD, which would develop several years from now, increasing the already existent smoking-related burden. The role of vaping and virus susceptibility is yet to be determined; however vaping can increase the virulence and inflammatory potential of several lung pathogens and is also linked to an increased risk of pneumonia. As it has emerged for cigarette smoking, great caution should also be given to vaping in relation to SARS-CoV-2 infection and the COVID-19 pandemic. Sadly, e-cigarettes are continually promoted and perceived as a safer alternative to cigarette smoking. E-cigarettes and their modifiable nature are harmful, as the lungs are not designed for the chronic inhalation of e-cigarette vapour. It is of interest; e-cigarettes have been shown to be of no help with smoking cessation. A true danger lies in vaping, of which if ignored, will lead to disastrous future costs.