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Vaping Cough: Vaping and Effects on Respiratory Health

Dr. Michelle Frank

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March 22, 2023
CoughPro is not a medical product. It is a wellness app intended only for users to obtain a better understanding of their cough. It is not intended to diagnose, monitor, or treat any illness.

We at Hyfe, Inc., are a company devoted to working on tools to better understand the importance of cough. It is Hyfe’s intention in the future to seek regulatory approval for medical products that analyze cough in order that they may be used to diagnose, monitor, and facilitate better treatment of respiratory illnesses.

A woman vaping

Vaping – smoking with e-cigarettes – has become a trendy substitute for smoking, especially among young people. Following the adoption of this trend, e-cigarettes have been linked with causing irreversible lung damage. This is particularly concerning because the vast majority using vapes believe it to be a healthier substitute to cigarette smoking, causing minimal to no harm to the respiratory system. One of the immediate indications that vaping might be impacting your lungs is a vaping cough. While it may or may not be persistent, it is prominent among those who regularly vape.

This article will highlight how to identify a serious vaping cough. We'll also discuss ways to reduce serious respiratory consequences related to vaping.

What Causes a Vaping Cough?

Vapes, pens, Juuls, and even hookahs can cause a vaping cough. While the devices might differ in the way they look, the vapors they produce irritate the respiratory tract, resulting in a cough.

Prolonged exposure to compounds in these vapors is one of the sources related to a vaping cough. While we still need to see studies to draw direct links from this to chemicals in vapes and coughs, there are some usual suspects which can be a cause.

Propylene Glycol

One of which is propylene glycol, the nicotine suspension agent in e-cigarettes. Studies have indicated this chemical is cytotoxic (harmful) to epithelial (lining) cells in the lungs. While it doesn’t result in outright damage, it can reduce the lungs’ immune response and also slow down the clearance of mucus by the cilia in the lungs. 1

Formaldehyde

Using a vape’s high-power settings or for prolonged use leads to the heating of the e-cigarette. This can result in the development of the toxic chemical formaldehyde2, perhaps better known for its use in embalming. Along with being a potential carcinogen, it has been associated with causing both restrictive and obstructive lung diseases.3

Acrolein

Another concerning by-product of vape burning is acrolein. People use this chemical as a weed killer. Investigations prove that acrolein is linked to acute adverse effects, leading to oxidative stress (an imbalance of free radicals and antioxidants) on blood vessels4. However, clinical studies are yet to prove whether it has a direct link to severe respiratory adverse effects, 

Faulty Devices

In addition to direct toxin exposure, vaping with faulty devices can cause coughing as well. Some of the causes include poor quality of the vaping liquid, bad atomizer, high polyethylene glycol or nicotine content, and inhaling any additional chemicals present in the vaporizer.

For those who previously smoked cigarettes, the transition to vapes could increase cough frequency. This is actually a sign your lungs are healing, especially the cilia, which help clear respiratory pathways, due to a decrease in chemical exposure. Coughing is a sign that your respiratory pathways are clearing themselves of tar and other cigarette debris.  

What Are The Symptoms of Lung Damage From Vaping?

Due to the common opinion that e-cigarettes result in less toxic damage to the lungs, people use them a lot more. This results in an increased incidence of vaping-related lung injuries.

Coughing and Wheezing

One of the first signs of lung damage due to vaping is coughing and wheezing. This can progress to difficulty in breathing, chest pain, fever, chills, and rapid heart rate.

Symptoms of lung injury can present as early as 90 days following the use of e-cigarettes. Men in their early 20s are more likely to present with vaping-related symptoms5

The most common health consequence linked to vaping is respiratory damage, followed by gastrointestinal signs and other constitutional signs such as weight loss and fever.

In 2019, the CDC recorded a spike of 2,807 hospitalizations due to an e-cigarette or vaping product-associated lung injury (EVALI)6. This spike was associated with vitamin E acetate found in some THC-containing e-cigarettes. While the majority of the cases were recorded among vapers between 18–24 years of age, about 15% of hospitalizations were of people less than 18 years.

During this wave of EVALI, some severe lung consequences were also documented.

A man vaping

Popcorn Lung

Bronchiolitis obliterans, popularly known as popcorn lung, is one such severe consequence of vaping. It receives its name from a lung injury originally found among workers in microwave popcorn factories. The exposure to the chemical diacetyl, used for a strong buttery flavor, resulted in scarring of the air sacs and narrowing of the respiratory pathways. A lot of e-cigarettes use diacetyl to complement flavors such as vanilla, fruit, candy, maple, or coconut. A 2015 Harvard study recorded the presence of this harmful substance in about 39 of 51 tested flavors of vapes easily available in markets7.

Collapsed Lung

Another concerning vaping-related hospitalization was due to a collapsed lung (pneumothorax). This complication was more frequently found among adolescents as their rapid rate of growth made their lungs vulnerable to blister formation. Regular vaping resulted in a rupture of these blisters, which caused lung collapse, which has recurred among those with previously documented pneumothorax due to vaping8.

Vaping-Related Lipoid Pneumonia

Another serious complication has been seen following exposure to oily substances in vapes. These substances have been linked to causing inflammatory changes and subsequently pneumonia-like symptoms. Patients with vaping-related lipoid pneumonia (pneumonia caused by fats entering the tubes in the lungs) presented with chronic cough, often coughing out blood, and shortness of breath. Vaping-related lipoid pneumonia also predisposes patients to developing severe viral and bacterial pneumonia, which are risk factors for extreme and rapid lung disease9.

Lung Cancer

As highlighted above, formaldehyde, one of the byproducts of vapes, is a potential carcinogen. Further concerning carcinogens are the derivatives of nicotine, a crucial substance in many vapes; Aromatic hydrocarbons; heavy metals; and complex organic compounds, which are all found in e-cigarettes10. Often these inhaled chemicals transform into more toxic substances following metabolism inside the body.

Are There Any Benefits To Vaping?

The only primary benefit of vaping over traditional cigarette smoking is that it limits the number of chemicals your lungs and the rest of your body are exposed to, as while vapes contain carcinogens and other harmful chemicals, they contain fewer of these than traditional cigarettes.

This means you are less likely to develop chronic lung conditions or cancers associated with cigarette smoking. Additionally, the risk of health conditions such as heart disease and stroke is lower with vaping.

Vaping often represents a transition to quitting smoking. However, it comes with its consequences, as described above, if used at the same or higher frequency as cigarette smoking.

A woman checking her phone and smoking

How Do I Stop Coughing After Vaping?

We have witnessed e-cigarettes and vaping-related lung injuries create an epidemic, especially among the youth. As a consequence, a persistent chronic cough typically lingers for habitual vapers.

To prevent coughing, the best thing to do is to quit vaping. A chronic cough can significantly deteriorate your quality of life11. Additionally, this cough is a sign that your respiratory tract is affected, which can indicate a lower threshold to developing serious lung injuries as a consequence of vaping.

Vaping dries out the throat. Staying hydrated can help curb some of the coughing. Using your vape on a higher power setting, higher temperature, or even using vapes with a higher nicotine hit can aggravate the cough.

Try to improve your lung capacity by exercising regularly and using more mindful breathing techniques. While these don’t work to prevent vaping-related lung injury, they can help with short-term effects such as coughing and wheezing.

Finally, if you have a persistent chronic cough and the onset of new symptoms such as shortness of breath, chest pain, or fever, check in with your doctor. A lot of vaping lung injuries, such as lipoid pneumonia or popcorn lung, may have an insidious onset with no outright symptoms. Early treatment and giving up the vape can help restore respiratory health.

The Bottom Line

Vaping has benefits for those who use it to transition out of regular cigarette smoking, with the intent to eventually quit the habit. But picking it up as a new habit, especially with addictive nicotine present, can have serious health consequences. Of interest is its impact on the lungs, which characteristically shows up as a chronic cough. Serious and sometimes irreversible respiratory consequences can ensue. 

References
  1. Lechasseur, A., & Morissette, M. C. (2020). The fog, the attractive and the addictive: pulmonary effects of vaping with a focus on the contribution of each major vaping liquid constituent. European respiratory review: an official journal of the European Respiratory Society, 29(157), 200268. https://doi.org/10.1183/16000617.0268-2020[]
  2. Salamanca, J. C., et al.(2018). E-cigarettes can emit formaldehyde at high levels under conditions that have been reported to be non-averse to users. Scientific reports, 8(1), 7559. https://doi.org/10.1038/s41598-018-25907-6[]
  3. Uthiravelu, P., Saravanan, A., Kumar, C. K., & Vaithiyanandane, V. (2015). Pulmonary function test in formalin exposed and nonexposed subjects: A comparative study. Journal of pharmacy & bioallied sciences, 7(Suppl 1), S35–S39. https://doi.org/10.4103/0975-7406.155787[]
  4. Mayer B. (2020). Acrolein exposure from electronic cigarettes. European heart journal, 41(15), 1523. https://doi.org/10.1093/eurheartj/ehaa002[]
  5. Layden, J. E., et al.(2020). Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin - Final Report. The New England journal of medicine, 382(10), 903–916. https://doi.org/10.1056/NEJMoa1911614[]
  6. Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products | Electronic Cigarettes | Smoking & Tobacco Use | CDC. (2021, August 3). Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html[]
  7. Pierce, J. S., Abelmann, A., & Finley, B. L. (2016). Comment on "Flavoring Chemicals in E-Cigarettes: Diacetyl, 2,3-Pentanedione, and Acetoin in a Sample of 51 Products, Including Fruit-, Candy-, and Cocktail-Flavored E-Cigarettes". Environmental health perspectives, 124(6), A100–A101. https://doi.org/10.1289/ehp.1611350[]
  8. Bonilla, A., Blair, A. J., Alamro, S. M., Ward, R. A., Feldman, M. B., Dutko, R. A., Karagounis, T. K., Johnson, A. L., Folch, E. E., & Vyas, J. M. (2019). Recurrent spontaneous pneumothoraces and vaping in an 18-year-old man: a case report and review of the literature. Journal of medical case reports, 13(1), 283. https://doi.org/10.1186/s13256-019-2215-4[]
  9. Kooragayalu, S., El-Zarif, S., & Jariwala, S. (2020). Vaping Associated Pulmonary Injury (VAPI) with superimposed Mycoplasma pneumoniae infection. Respiratory medicine case reports, 29, 100997. https://doi.org/10.1016/j.rmcr.2020.100997[]
  10. Bracken-Clarke, D., Kapoor, D., Baird, A. M., Buchanan, P. J., Gately, K., Cuffe, S., & Finn, S. P. (2021). Vaping and lung cancer - A review of current data and recommendations. Lung cancer (Amsterdam, Netherlands), 153, 11–20. https://doi.org/10.1016/j.lungcan.2020.12.030[]
  11. Jin, H. J., & Kim, C. W. (2020). Understanding the Impact of Chronic Cough on the Quality of Life in the General Population. Allergy, asthma & immunology research, 12(6), 906–909. https://doi.org/10.4168/aair.2020.12.6.906[]

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    I had an issue logging into the new app but I contacted the support team and they were awesome in helping me figure out the issue. It turned out to be a technical issue which they resolved very quickly and I was kept in the loop on the status from start to finish. This app is really helpful when talking to my doctor too..
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    Just installed the app. Very accurate measuring coughs so far! Cannot wait to see how much coughing I do while sleeping. I'll have a better picture to discuss with my physician at my next visit.

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