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Journal Article

Citation

Hooper RW, Garfield JL. Ann. Intern Med. 2019; ePub(ePub): ePub.

Affiliation

Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania (J.L.G.).

Copyright

(Copyright © 2019, American College of Physicians)

DOI

10.7326/M19-2908

PMID

31590182

Abstract

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 VAPI 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 healthier alternative to smoking and has been promoted as a means to assist in smoking cessation. Children and adolescents are also targeted through flavorings that appeal to a younger market and via social media promotion. The resulting increase in popularity of nicotine vaping has helped to grow a vaping constituency in the cannabis industry and extend the use of vaping technology for illicit substances, such as dimethyltryptamine or methamphetamine (1).

Clinicians should consider VAPI in patients who present with clinical symptoms of respiratory illness within 90 days of vaping. Many patients present initially in the outpatient setting with gastrointestinal symptoms, including nausea, vomiting, and diarrhea; constitutional symptoms, such as fever and malaise; and/or respiratory symptoms, such as shortness of breath, cough, or pleuritic chest pain. Patients develop infiltrates on plain film or ground-glass opacities on computed tomography along with hypoxia and an elevated leukocyte count in the absence of...


Language: en

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