I am a physician and have personally treated, while in residency, teenagers and "adults" in their early twenties with lungs worse than a coal miner. Bronchiolitis obliterans is a horrible thing and something that should be a rarity in clinical practice, however, all these patients had one thing in common: diacetyl that is found in nearly all vaping juices (not to be confused with vitamin E acetate). Diacetyl is well studied, there is consensus and it is known to be dangerous to your health.
Further studies are still needed, but not because we lack consensus or sufficient insight with statistically significant p-values. We try to honor evidence based medicine and biostatistics in striving to design studies with more power, fewer errors, and minimal bias.
There was recently an example of a teenager that underwent bronchoscopy due to progressive dyspnea at rest (shortness of breath). Gobs of vaping juice (that was not vaporized) mixed with the body's natural defenders to form rather large plugs (noncaseating granulomas). Bronchoalveolar lavage was done and the kid could breath again, though complete recovery of lung function is unlikely. I have also seen the same illness in mid-40s men - incomplete vaporization led to an accumulation of vaping juice in the respiratory tree where the body's macrophages walled off the substance and formed granulomas.
We (the body of evidence based medicine) already know what pneumonitis leads to (incredibly common among vape users). Respiratory infections are increasing among those who vape. The mucocilliary system along the respiratory tree is dysfunctional just as with cigarettes - this same system that provides many of the symptoms in patients with CF. Many of the vaping juices come off the boat from China, early studies with murinae demonstrate mutogenic and carcinogenic potential of vaping liquids. Of course, many prospective studies are underway and many retrospective cohorts will be examined in the not-so-distsnt future. We are looking at mutogenic and carcinogenic compounds delivered into a vascular rich zone of the lungs with greatest perfusion. These chemicals being investigated are not the California prop-65 everything causes cancer type but real, legitimate, cancer-causing-screw-the-two-hit-hypothesis agents. There are also a myriad of implications beyond affects on lung pathophysiology (number one risk factor in bladder cancer is smoking, same goes for renal cell carcinoma not cause by VHL).
Bottom line: vaping is hazardous to your health, just as smoking cigarettes. Use the real thing if you are going to do it - at least we have more than a hundred years of scientific research, generally no surprises when a smoker falls ill.
While you are at it, go out to the local coffee shop and pick up a coffee stirrer. Take the deepest breath in that you can and then blow it all out through a coffee stirrer. That is the sensation you will experience as the damage to your lungs progresses to COPD. Some of the worst suffering I've witnessed.
If anyone would like help quitting, contact your 800 quit line. If you tried cold turkey (best method, it is what I did), then try the gum. If you tried the gum, then try the lozenges. Give the patch a whirl. Take an antidepressant with very high success rates. Try hypnosis. Join a gym. Get an accountability buddy. Lastly, ask for a medical-grade "vaping" device, the nicotine inhaler.
Every doctor on the planet would be super pumped if vaping was a safe alternative to cigarettes! Nonetheless, I am sorry to report they are not safe and carry a similar risk profile to anything you inhale deeply into the lungs.
I'll get off my soapbox now and return to pinball. Well, pinball once I put in work, nessun riposo per i malvagi!
