Question
What is popcorn lung?
Answer
Some of the chemicals with vaping are very similar to traditional cigarettes. We know that nicotine is a highly addictive substance that negatively affects the brain, particularly in teens and individuals who are still developing. Propylene glycol is a common additive in food that can also be used to make things like antifreeze, paint solvent, and artificial smoke and fog. Acrolein is a herbicide primarily used to kill weeds that has been directly linked to lung damage. Diacetyl is a chemical linked to a lung disease called bronchiolitis obliterans, which is commonly known as "popcorn lung."
I will talk a little bit more about that in a second. Diethylene glycol is a toxic chemical associated with antifreeze and has also been directly linked to lung disease. One of the major takeaways from this is not only are these different chemicals and different ingredients in e-cigs, but they also have ultrafine particles. We know as RTs and healthcare providers, particle size plays a huge role in deposition. If there are smaller particles, then these chemicals can travel further and go deeper than the traditional methods of smoking. Thus, we are now seeing a different effect of vaping as compared to smoking. I think this is one of the main reasons that this popcorn lung has come about. Not only is this a new ingredient that has not been inhaled before, but it is also able to reach deeper down into the lungs as we are vaporizing it at smaller particle sizes.
Looking at popcorn lung a little closer, diacetyl is an organic compound found in foods such as popcorn. It is what gives it the buttery flavor. If you are thinking, "Oh my gosh! I have made microwave popcorn all my life. Is this going to cause me to have some kind of lung disease now?" No. Diacetyl is approved for ingestion, and there are no known concerns when you inhale it. Inhaling is another story. In fact, bronchiolitis obliterans is where you basically cause permanent scarring to the lung. This component is used for flavoring, and those making e-cigs thought flavoring would increase their popularity. There are currently over 7,000 flavors on the market, and many are fruit-flavored. They also replicate alcohol flavors, menthol, cookies, cakes, other sweets, and a combination of any and all of those. One study in 2016 studied 51 different brands and flavors to find out if diacetyl was present in them. Almost 75% of them contained diacetyl. This is definitely not an ingredient that you want to be entering into your lungs.
This Ask the Expert is an edited excerpt from the course, Tobacco Management and Smoking Cessation, presented by Jessica Fino, EdD, RRT.
