Electronic cigarette (e-cigarette) use and vaping have dramatically increased in recent years, particularly among teenagers and young adults, with an estimated 7.6% reporting current, everyday e-cigarette use and 27.5% reporting use in the past 30 days (1, 2). The exact numbers of nicotine vapers who also vape marijuana are unknown, but there is significant overlap, with young adults who use e-cigarettes having an adjusted odds ratio of concurrent marijuana use of 3.47 (3). In 2019, e-cigarette or vaping product use–associated lung injury (EVALI) was recognized as a unique disease entity, and rapid escalation of the numbers of those affected was such that it has been labeled a public health crisis, with over 2800 cases of hospitalizations and 68 deaths as of March 2020. Individuals affected are predominantly males (66%) who use tetrahydrocannabinol-containing (THC-containing) vapes (82%). However, many EVALI patients report using both nicotine and THC products (43%) (4). Interestingly, there is significant clinical overlap between the EVALI epidemic and the COVID-19 pandemic. Both of these diseases have substantial gastrointestinal symptoms, bilateral lung infiltrates, and significant numbers of those affected progressing to hypoxic respiratory failure and acute respiratory distress syndrome (ARDS). But whereas EVALI is mainly a disease of the young, with a median age of 24 years, severe COVID-19 is primarily a disease of the elderly. Although smoking has been linked to increased COVID-19 severity (5), it is as yet unknown whether vaping increases the susceptibility to or severity of this novel viral illness ...
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", language="en", issn="0021-9738", doi="10.1172/JCI138644", url="http://dx.doi.org/10.1172/JCI138644" }