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Up in Smoke: The Vaping Epidemic

The importance of lung health is more significant this year than ever before. The combination of the COVID-19 pandemic and flu season is enough to convince anyone to take an extra dose of vitamin C. However, one widely neglected component of lung health is the impact of vaping. Teens and young adults may be wearing masks and social distancing, but when they choose to use e-cigarettes, Juuls, or other vaping devices, they put their lung health at risk.

Since the development of electronic cigarettes in 2007 as an aid to quit cigarette smoking, teenagers without nicotine dependency have become the targeted consumers. During 2015-2017, the use of any tobacco products among high school students was steadily decreasing (1); however, for the first time in 17 years, there has been an increase in use among adolescents. Because e-cigarettes weren’t viewed as a treatment for cigarette dependency, the FDA didn’t subject them to the same regulations and advertisement restrictions as traditional cigarettes which allowed teenagers to be exposed to and purchase such products with great ease (1). We are now entering a vaping epidemic: patients who vape are developing nicotine dependency, permanent vaping-related lung injury (VRLI), and a teenage patient has even required a double lung transplant in October 2019 (2). Worse yet, vaping is a gateway substance for further drug misuse. These serious effects of vaping are largely unknown or are ignored by teenagers and the cycle of use and harm continues.

Brittany LadsonBrittany Ladson

Often times, people think certain situations will never affect their lives. For instance, when you hear of someone being kidnapped or a plane crashing into someone’s house, you never think it will happen to you. That’s something that you hear on the news or see in a movie. This is a commonality with vaping. People think addiction will never happen to them because their willpower is too strong. They will never be the one hospitalized for a vaping-related lung injury because they are young and in great overall health. And, certainly, they will never need a lung transplant because that is something you only see on medical dramas on television. This is flawed thinking for obvious reasons. Over 60% of teens believe that occasional e-cigarette use is not harmful while 52% of hospitalized patients with irreversible lung injury are also in this same age group (Chapman et al. 2019). Clearly, youth education is vital.

In October 2019, a 17 year old teen made national headlines when he was admitted to Henry Ford Hospital in Detroit for a double lung transplant due to a vaping-related lung injury. His life was sustained on ECMO, a machine that functions as your heart and lungs, and he underwent a six hour long procedure to replace both lungs. His condition was so urgent that he was bumped to the top of the national lung transplant waiting list. Dr. Hassan Nemeh, the teenager’s thoracic surgeon, said, “The lung itself was so firm and scarred- this is an evil I haven’t faced before.” This patient’s life changed from one of playing video games and hanging out with friends to being hospitalized, intubated, and being put under the knife (2).

To combat this growing crisis, five osteopathic medical students, Basma Al Masraf, Brittany Ladson, Saaranga Sasitharan, Maricar Gener, and Max Volk, have developed a high school education program to educate students on the dangers of vaping. Throughout the 2021 spring semester, students at East Lansing High School in Ingham County and Romeo High School in Macomb County were educated on topics ranging from short term and long term health consequences of vaping, the substances found in e-cigarettes, how e-cigarettes compare to traditional cigarettes, and where to go if they need help quitting. This project was developed from a previous education program focusing on the opioid epidemic implemented by the same team. During 2019-2020, they demonstrated that the opioid interventional education program had a statistically significant impact on the students’ self-reported confidence on opioid knowledge.

Identical teaching methods were used between the opioid and vaping programs with the main difference being a virtual implementation of the vaping program due to the COVID-19 pandemic. Students watched clips from a documentary about a teenager who vaped regularly and was hospitalized, listened to testimonies from survivors, had a Q+A session, and were encouraged to have group discussions in Zoom breakout rooms in order to remain engaged during the program. After analysis of the post-session surveys, it was shown that Romeo High School students had a statistically significant increase in self-reported confidence of their vaping knowledge. However, the sample size for East Lansing High School was too small and data was deemed statistically insignificant. Nonetheless, there appears to be a role for early education intervention on substance misuse disorder, whether it be about opioids, vaping, or any other drug. The data gained from this program will be used to advocate for early drug prevention education programs in high schools statewide. It is our objective to have all public schools in Michigan implement this educational program to help save the health and lives of the future of our society.

If you are looking for help to quit smoking or vaping, resources are available:

American Lung Association:

Drug Watch:


  1. Jones K, Salzman GA. The Vaping Epidemic in Adolescents. Mo Med. 2020;117(1):56-58.
  2. Lanese N. A Teen’s Lungs Were So Badly Damaged from Vaping, He Needed A Double Lung Transplant. Live Science. 2019.

Brittany Ladson is a student at Michigan State University College of Osteopathic Medicine. 

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