Tobacco Treatment Specialist on E-Cigarettes and Popcorn Lung

Dr. Colin Mendelsohn, a Tobacco Treatment Specialist based in Australia, answers the question of whether e-cigarette use puts vapers at risk of popcorn lung in a recent blog post on his official website:

Does vaping cause Popcorn Lung?

Answer: NO

A 67-year old patient of mine quit smoking earlier this year by switching to an e-cigarette, an impressive achievement after 50 years of smoking 20 cigarettes a day. He found using an Innokin T22 with nicotine-free e-liquid '90% as satisfying as smoking'. Recently a friend told him he could get 'popcorn lung' from vaping, so he stopped immediately and has been smoking several cigarettes a day since. Popcorn lung (bronchiolitis obliterans') is a serious lung disease that has been found in some people working in popcorn factories. It is thought to be caused by exposure to a chemical called 'diacetyl' which is used to give popcorn a buttery flavour.

What is the risk of popcorn lung?

Reports that diacetyl was found in some e-liquids created panic that vapers may get popcorn lung (1). However, subsequent studies have shown that the level of diacetyl in the aerosol is 100-750 times LESS than in cigarette smoke (2, 3), and there has NEVER been one reported case of popcorn lung from smoking. The risks from diacetyl in vapour are so small as to be irrelevant. On the other hand, the risks from continuing to smoke are devastating. My patient has already had two episodes of lung cancer. Even though the health risk from diacetyl is almost non-existent, responsible manufacturers are removing diacetyl from their e-liquids and many are now labelled 'diacetyl-free'. The supplier I recommend for my patients has eliminated diacetyl from all their e-liquids which are certified 'diacetyl-free' (Nicopharm). These scary headlines sell newspapers but are clearly misleading and can cost lives by creating fear about a life-saving treatment. E-cigarettes are at least 95% less harmful than smoking, even with diacetyl. Returning to smoking is the worst thing any ex-smoking vaper can do for their health.