E-cigs Lipoid Pneumonia

Can E-Cigarettes Cause Lipoid Pneumonia?

Yahoo News Vaper Pneumonia
– Source: Yahoo News

There are 2.5 million vapers in the UK. An estimated 30 million people have vaped in America, and there are many millions more around the world.

Two of them have experienced a case of lipoid pneumonia.

Both were former smokers.

Despite the numbers, some now believe e-cigarettes can cause lipoid pneumonia.

As we know, smoking carries a hugely increased risk of an early death. E-cigarettes, on the other hand, are significantly safer than tobacco cigarettes according to leading scientists.

And specialists in e-cigarette research fear that many smokers are now choosing to stick to tobacco cigarettes as a result of these stories.

To find out if vaping can pneumonia, we interviewed one of these experts, Professor Riccardo Polosa . In this interview he discusses lipoid pneumonia – and whether vapers need to worry about it.

About Professor Polosa,MD, PhD

Prof PolosaPolosa is Director of the Institute for Internal Medicine & Clinical Immunology of the University of Catania (Italy). He is also in charge of the University Centre for Tobacco Research (University of Catania) & Honorary Professor of Medicine at Southampton University (UK). He and his team have led several studies on e-cigs.

Lipoid Pneumonia and Vaping

JD: How did the idea that vaping leads to lipoid pneumonia arise?

RP: Lipoid pneumonia is a rare respiratory illness that may occur from aspiration or inhalation of fatlike material in the lung; this has been reported in elderly people after accidental ingestion of oil-based laxatives.

There is no way vaping could put people at risk for lipoid pneumonia simply because vaporization of commercially available e-liquids do not contain fatlike material. However, I am aware of two reports of lipoid pneumonia that respiratory physicians in the US and subsequently in Spain have suggested being direct consequence of vaping.

After careful review of these clinical cases, I could identify a more plausible cause for these patients’ lipoid pneumonia. I do not understand why my colleagues incriminated vaping. Most probably, they (erroneously) reasoned that inhalation of vegetable glycerine in the e-liquid could have been the cause without considering that glycerin is not a lipid, but an alcohol. By definition alcohol cannot cause lipoid pneumonia.

There is no way vaping could put people at risk for lipoid pneumonia – Prof. Polosa

JD: Do vapers need to be worried about oils in e-cigarettes causing lipoid pneumonia?

RP: The presence of essential oils is not uncommon in some e-liquid flavourings (particularly in citric fruits, menthol). However, essential oils are not oils (not lipids) in a strict sense; the term “oil” in essential oil is a misnomer. Hence, they cannot cause lipoid pneumonia.

Essential oils are to be distinguished from aroma oils (essential oils dissolved in an oily solvent).

Clearly, the presence of essential oils may be potentially irritant and hypersensitivity could develop in susceptible individuals. But this is a different story.

JD: Are there any types of oil based flavourings that could lead to lipoid pneumonia?

Not that I am aware of (but see answer below).

Mixing e-liquids

JD: Do vapers need to take care when mixing their own e-liquids?

RP: In principle I do not recommend mixing because mistakes and contamination may happen at home.

In relation to accidental exposure to fatlike material, when blending their own DIY mixtures, vapers should make sure that flavouring solutions are free of fatlike material such as vegetable oil.

I have heard stories of essential oils (not fatlike material) sold in pharmacies for massage therapy that are dissolved in oily solvents (usually vegetable oil). This may be a problem because chronic inhalation of such DIY mixtures could theoretically lead to lipoid pneumonia.

JD: What consequences has this rumour lead to?

RP: The lipoid pneumonia case received such an emotional and widespread media coverage in Spain that Spanish vapers ended up being very concerned about the possibility of developing serious vaping-related lung diseases.

Spanish pneumologists have campaigned aggressively against e-cigs. These two factors have contributed to destroy the positive “image” of these products, to shift the perceptions of consumers from benefit to harm and – as a consequence – to the collapse of the e-cig market in that country.

If you’ve found this interview interesting, I’d love it if you could take a second to share it using one of the buttons below. 

Thank you 😉

Further reading

Campagna et al, Respiratory infections and pneumonia: potential benefits of switching from smoking to vaping, Pneumonia 2016 8:4, https://doi.org/10.1186/s41479-016-0001-2

11 thoughts on “Can E-Cigarettes Cause Lipoid Pneumonia?”

  1. I had contracted pneumonia last year as a result of a flu. In addition, I was vaping heavily all sorts of liquids. I believe that whilst the pneumonia (a case of obliteration) may not have been a direct cause of vaping, I strongly believe that vaping had facilitated and even exacerbated the condition. I almost died from pneumonia with a temperature of 41 degrees. I am not going to demonise vaping or say how you should not do it. Personally, I think vaping is very dangerous and will keep away from it. Putting anything in your lungs is unhealthy. If you want to quit smoking, do not look for excuses or aids, use your will power. If you have none, you should work on developing your will power rather than looking for easy answers.

    1. I absolutely agree that from a health point of view quitting 100% is better than vaping. However, my wife also had pneumonia last year. She does not smoke or vape. Just because you have pneumonia and vape does mean that it is because you have vaped. Correlation does not mean causation!

    2. With all due respect Fat Cat, saying that we should all develop our will power and just quit is not very understanding is it? With that logic we could just say to all drug addicts (cocaine, heroine etc) to just develop your will power and all will be well. Alcoholics, just will power guys, gambling ? just takes developing your willpower guys. Maybe Fat Cat should take some of his own advise (eg: stop looking for easy answers). If the answer (just develop will power) was the ‘easy’ answer to the problem, there would be no problems.

      The 50,000 Opiate deaths in the US (per year) would not be happening. (and they are prescribed by the regulated US State (FDA). ( and the US deems 20 or so deaths from Black Market Illegal Cannibis Cartridges an Epidemic??? and puts all the blame on ‘Vaping’ but 50,000 from Opiates is acceptable…(cause that number has been climbing for years…from 17,000 in the year 2001 to over 50,000) Fat Cat states “Putting ‘anything’ into your lungs is dangerous”? How about vaping CBD ? Is putting CBD into your lungs dangerous ? When an Asthma sufferer is putting an inhaler (containing propylene Glychol ) into their lungs…is that dangerous ?

      50,000 Opiate deaths a year… 1,500,000 Road deaths a year…8,000,000 tobacco deaths a year. How many lives could vaping save ? Millions ? and here we are talking about how many lives are ‘lost’ through vaping nicotine e-liquids. Takes all sorts to make up this crazy world I suppose. For the moment, I’ll take the risk of vaping against those 8 million tobacco deaths and the 1 in every 2 will die from tobacco odds. As long as the vaping figure stays below the 8 million figure per year, I’ll hang in there.

      I won’t even go into how many hairdressers are breathing in chemicals from hairsprays for the past 50 years and colour dyes etc and the pletora of other fumes we breath in…buses, cars, trucks etc …Oh yeah, I said I wasn’t going to go into that didn’t I lol …but ya get my drift yeah. If anyone is a ‘tobacco’ smoker reading this…get the info about vaping and then consider getting away from the proven ( and that proof is 100% undisputed by 100% of the white coats) killer of ‘tobacco’ and consider vaping as an alternative to your nicotine addiction. Good luck and good health (or at least harm reduction) to all.

  2. This is my worry. I’ve got a sub ohm tank and it produces tons of condensation to the point my nose is just dripping with vapor water some days. Also the vapor leaves a greasy oily film on my car windows. Put two and two together….and it can’t be good for your lungs. However, im asthmatic and have used my meds less since switching from a standard nautilus tank to the Smok Baby Beast sub tank. But, I can’t help but wonder if all that greasiness left on my car windows is also building in my lungs. I’m prone to pneumonia.

    1. First, the condensation is not causing your nose to run. When you exhale vapor out of your nose, that’s what makes it run. Ask anybody. Second, vapor will stick to your car windows, but once it’s there’s, it’s there. Also, the only “oily feel” substance in vaping is Vegetable Glycerin. Same thing that causes your nose to run, is an alcohol. So by definition, glycerin cannot cause lung problems. Third, you used your meds less because you switched tanks? Dear Lord have you lost your mind? They have nothing to do with asthma. And forth, you really should not be vaping at all. Like AT ALL. Oh, and if you’re looking for someone to sue, another person just like me will debunk everything you have to say. Get some smarts.

  3. Being called lipid or not is matter of biochemistry terminology but if it feels like oil to the finger then it may be oil to the lungs. Common sense tells me vaping can lead to pneumonia of some sort. I just started e cig but I don’t feel that sure that I changed to a safer method but yes a cheaper method compared to cigarettes.

    1. People, PLEASE do a bare minimum amount of reading before ASSuming. It’s exactly this kind of thing that leads to a lot of ‘Chicken Littles’ running around saying “The sky is falling! The sky is falling!” because they felt a raindrop.. And because clouds contain moisture, must mean that the sky is indeed falling.

      As already just posted above, just ONE comment prior, at this link (again): https://www.ecigarettedirect.co.uk/ashtray-blog/2015/10/ecigs-water-vapour-lungs.html

      Or for people that can’t be bothered to click a link:

      Riccardo is an expert in respiratory medicine, clinical immunology, and tobacco addiction, Chief Scientific Advisor for Lega Italiana Anti Fumo (LIAF), the Italian Anti-Smoking League, and one of the world’s leading experts on e-cigarettes.

      Here was his response:

      “This is ridiculous! You would get more water vapour from a home nebulizer designed to deliver COPD medications than you would get from an electronic cigarette.”

      “We’ve also examined the effects of regular electronic cigarette usage on people with COPD, and found that respiratory symptoms were never triggered by e-vapour; moreover, in these patients we have shown an overall improvement in both subjective and objective respiratory outcomes after switching from tobacco cigarettes to electronic cigarettes.”

      “What’s more, PG in aerosol form is an effective antibacterial and antiviral agent that is likely to prevent infections of the respiratory tract. Ironically, far from creating an ideal condition for germs to multiply and spread, PG vaping could be a practical and safe way to prevent COPD exacerbations.”

  4. Hi James,
    I just read the paper you posted – https://www.hindawi.com/journals/cripu/2020/7151834/

    I am still unsure about the specific contribution of extracts (not mixed with PG or VG), to these sort of lung conditions. These seem to exclusively be the form of vape cartridges sold in the US on sites like https://www.eaze.com/menu (i.e. not mixed with PG or VG) so I was wondering whether there is some health guidance underpinning that fact that US providers use extracts as oppposed to PG/VG bases as providers in the UK tend to?

    Many thanks

    1. I am unaware of guidance for the US, I’m afraid. There are specific substances that are banned in the EU, and there has also been substantial research by some UK manufacturers to identify and eliminate potentially harmful ingredients.

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