An Emerging Crisis: Vaping-Associated Pulmonary Injury
Authors: Randol W. Hooper, Jamie L. Garfield
Journal: Annals of Internal Medicine (2019)

Ideas and Opinions7 January 2020An Emerging Crisis: Vaping-Associated Pulmonary InjuryRandol W. Hooper II, MBBS, MS and Jamie L. Garfield, MDRandol W. Hooper II, MBBS, MSTemple University Hospital, Philadelphia, Pennsylvania (R.W.H.)Search for more papers by this author and Jamie L. Garfield, MDLewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania (J.L.G.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-2908 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The year 2019 has seen the emergence of vaping-associated pulmonary injury (VAPI) as reports of morbidity and mortality continue to rise throughout the United States. Even though the cause or causes of such injury remain unclear, physicians must consider vaping behavior in everyday patient care.“Vaping” refers to the heat-induced aerosolization of a liquid using a battery-powered device. The rise of vaping as a public health phenomenon and the emergence of VAPI coincide with the decreasing social acceptance of cigarette smoking coupled with the legalization of medical and recreational cannabis. Despite insufficient evidence, nicotine vaping has been marketed as a ...References1. Breitbarth AK, Morgan J, Jones AL. E-cigarettes—an unintended illicit drug delivery system. Drug Alcohol Depend. 2018;192:98-111. [PMID: 30245461] doi:10.1016/j.drugalcdep.2018.07.031 CrossrefMedlineGoogle Scholar2. Schier JG, Meiman JG, Layden J, et al; CDC 2019 Lung Injury Response Group. Severe pulmonary disease associated with electronic-cigarette-product use—interim guidance. MMWR Morb Mortal Wkly Rep. 2019;68:787-90. 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[PMID: 31377138] doi:10.1016/j.fct.2019.110727 CrossrefMedlineGoogle Scholar8. He T, Oks M, Esposito M, et al. “Tree-in-bloom”: severe acute lung injury induced by vaping cannabis oil [Letter]. Ann Am Thorac Soc. 2017;14:468-70. [PMID: 28248584] doi:10.1513/AnnalsATS.201612-974LE CrossrefMedlineGoogle Scholar9. Layden JE, Ghinai I, Pray I, et al. Pulmonary illness related to e-cigarette use in Illinois and Wisconsin - preliminary report. N Engl J Med. 2019. [PMID: 31491072] doi:10.1056/NEJMoa1911614 CrossrefMedlineGoogle Scholar10. Steigerwald S, Wong PO, Cohen BE, et al. Smoking, vaping, and use of edibles and other forms of marijuana among U.S. adults [Letter]. Ann Intern Med. 2018;169:890-2. [PMID: 30167665]. doi:10.7326/M18-1681 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Temple University Hospital, Philadelphia, Pennsylvania (R.W.H.)Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania (J.L.G.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-2908.Corresponding Author: Randol W. Hooper II, MBBS, MS, Department of Thoracic Medicine and Surgery, Temple University Hospital, 3401 North Broad Street, Philadelphia, PA 19140; e-mail, Randol.[email protected]temple.edu.Current Author Addresses: Dr. Hooper: Department of Thoracic Medicine and Surgery, Temple University Hospital, 3401 North Broad Street, Philadelphia, PA 19140.Dr. Garfield: Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, Philadelphia, PA 19140.Author Contributions: Conception and design: R.W. Hooper, J.L. Garfield.Analysis and interpretation of the data: J.L. Garfield.Drafting of the article: R.W. Hooper, J.L. Garfield.Critical revision of the article for important intellectual content: R.W. Hooper, J.L. Garfield.Final approval of the article: R.W. Hooper, J.L. Garfield.Administrative, technical, or logistic support: R.W. Hooper, J.L. Garfield.Collection and assembly of data: J.L. Garfield.This article was published at Annals.org on 8 October 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoVaping-Associated Pulmonary Injury Randol W. Hooper II and Jamie L. Garfield Vaping-Associated Pulmonary Injury Matthew R. Norris Metrics Cited byImaging in Vaping-associated Lung Injury: Beyond the HazeMedicinal Cannabis: an overview for health-care providersAll up in smoke: vaping-associated lung injuryVaping-Associated Pulmonary InjuryMatthew R. Norris, MDCase of Pneumonitis Associated With Cannabis Vaping and Cancer ImmunotherapyRecent advances in the understanding of bronchiolitis in adultsIntersection of the Web-Based Vaping Narrative With COVID-19: Topic Modeling Study 7 January 2020Volume 172, Issue 1Page: 57-58KeywordsCannabisCannabis useHospital medicineInhalationNicotineOilsPneumoniaPneumonitisThoracic surgeryToxicity ePublished: 8 October 2019 Issue Published: 7 January 2020 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...