Electronic nicotine delivery systems, also known as electronic cigarettes (e-cigarettes) were first introduced in the United States in 2007, as alternative tobacco products to deliver nicotine without tobacco smoke.1 These are devices that produce an aerosol by heating a liquid that contains a solvent (vegetable glycerin, propylene glycol) in one or more flavorings, with or without nicotine.2 The evaporation of the liquid at the heating element followed by rapid cooling forms the aerosol, which is inhaled, or “vaped.”2
E-cigarettes have been traditionally considered to be less harmful compared with cigarette use, as they are not associated with the inhalation of combustible products of tobacco, which are more carcinogenic, and have deleterious effects compared with nicotine alone.
E-cigarettes, however, have been associated with a variety of health effects; cardiovascular effects including increased odds of myocardial infarction;3 thermal injuries4 due to explosions, causing significant soft tissue and facial injury;5 and psychosocial effects secondary to addictive behavior. Pulmonary complications (Table) were reported rarely and sporadically.3 However, since March 2019, an ongoing outbreak of e-cigarette- or vaping-associated lung injury with multiple fatalities has been reported all over the United States
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-Sujith V. Cherian, MD, FCCP, Anupam Kumar, MD, FCCP, Rosa M. Estrada-Y-Martin, MD, MSc, FCCP
