Why Are Dozens of US Teens Getting Sick After Vaping?

A patient in the ICU. — (Image credit: Shutterstock)

UPDATE: On Aug. 21, the Centers for Disease Control and Prevention announced that there are now 149 possible cases of severe lung illness associated with vaping reported in 15 states.

Vaping has sent nearly 100 people, mostly teens and young adults, to the hospital with lung illnesses in the last couple of weeks.

For example, pneumonitis has been linked to the practice of "dabbing," or inhalation of butane hash oil, a concentrated form of marijuana that contains high levels of the drug's active compound, THC. Heating butane hash oil to high temperatures may result in the formation of chemicals that are toxic to the lungs, according to a report published in the journal Respiratory Medicine Case Reports last January.

But other experts say that noncannabis e-cigarettes, those that contain nicotine instead of THC, could also cause such reactions. A group of researchers recently found that nicotine releases potentially harmful enzymes — molecules that have a role in breaking down proteins in the body — into the lungs. Those researchers published their results on Aug. 7 in the American Journal of Respiratory and Critical Care Medicine.

Previous research into e-cigarettes has found multiple chemicals in the vapor that can damage cells and trigger inflammation in the lungs and in the bloodstream, said Dr. Laura Crotty Alexander, an associate professor of medicine at the University of California, San Diego. "It could be a particular chemical in the e-cigarette vapor or multiple different chemicals leading to acute lung injury," Crotty said.

An acute lung injury means that the cells of the lungs have been damaged and the immune system has responded to try and stop the damage and heal the lungs. Because of inflammation and cell damage, gas exchange in the body is "impaired" such that patients are short of breath, deprived of oxygen and often coughing, Alexander said. This could be caused by store-bought or street-bought e-cigarettes, she said.

A study published today (Aug. 20) found that right after vaping a non-nicotine-containing e-cigarette, participants had much less oxygen flowing through their blood. "We could only conjecture at this point" about whether this finding could help explain the mysterious vaping-related illness, said, Felix Wehrli, senior author of the study and a professor of radiologic science and biophysics at the University of Pennsylvania Perelman School of Medicine.

Most e-cigarette liquids contain three major components: propylene glycol, glycerol and nicotine, Alexander said. But when you heat these components into a vapor, you create completely different chemicals, some of which are toxic, such as formaldehyde and acrolein. "But because there's new e-cigarettes and e-liquids coming on market at least every month, it's impossible to keep up with all the different chemicals that are being sold and breathed in," she said.

What's more, the Food and Drug Administration isn't actively regulating these devices, she said. The administration doesn't require companies to label products with all the ingredients, and the ones that are labeled are often wrong, she said. As for the e-cigarettes sold on the street, what's in them is even more unclear, she said. So her advice to teenagers is "if somebody hands you one of these devices at a party, do not use it," she said. "Because you have no idea what's in it."

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Yasemin is a staff writer at Live Science, covering health, neuroscience and biology. Her work has appeared in Scientific American, Science and the San Jose Mercury News. She has a bachelor's degree in biomedical engineering from the University of Connecticut and a graduate certificate in science communication from the University of California, Santa Cruz.