Recently, an American teenager was diagnosed with a rare but serious condition: bronchiolitis obliterans, nicknamed "popcorn lung." This irreversible disease affects the smallest airways in the lungs, causing persistent coughing, wheezing, fatigue, and shortness of breath.
The term "popcorn lung" dates back to the 2000s, when an outbreak of lung problems was observed among employees of a microwave popcorn factory who were exposed to a flavoring, diacetyl, which is responsible for the characteristic buttery aroma.
Diacetyl (2,3-butanedione), in its gaseous state, is a potent bronchiole toxicant, causing inflammation, scarring, and narrowing of the airways. The result is permanent, often disabling, lung damage.
Besides diacetyl, other inhaled substances, such as formaldehyde and acetaldehyde – also present in e-cigarette vapors – can cause similar effects.
The findings are alarming: no therapy exists to reverse the damage caused. Treatment is limited to symptomatic control with bronchodilators, corticosteroids, or, in extreme cases, a lung transplant. Prevention therefore remains paramount.
The trap of vaping among young people
E-cigarettes are particularly popular among teenagers and young adults, drawn to a myriad of delicious flavors ranging from bubble gum to frozen mango. However, these flavors are created from potentially dangerous chemical mixtures.
Many of these flavoring agents are permitted in food, but inhaling them poses a completely different risk. When ingested, they undergo detoxification by the liver. When inhaled, they directly penetrate the lungs and reach the bloodstream, affecting vital organs within seconds.
The popcorn factory tragedy serves as a reminder of this critical difference: eating flavored corn is harmless; inhaling the flavoring vapors is catastrophic.
The chemical complexity of vaping
The situation is further complicated by the variety and quantity of chemical compounds used. It is estimated that over 180 different flavoring agents are present in current vaping products. Under heating, these substances can transform into new compounds that have not been tested for pulmonary exposure.
Although diacetyl has been removed from some formulas, its replacements, such as acetoin and 2,3-pentanedione, may be just as harmful. Cumulative exposure to various chemicals could thus increase the risk of serious respiratory illnesses.
The recent case of the American teenager is reminiscent of the 2019 epidemic linked to cannabis vaping products, where vitamin E acetate, a thickening substance, was identified as responsible for the production of a toxic gas called ketene.
Recent research confirms that adolescent vapers experience a significant increase in respiratory symptoms, even after accounting for their smoking status. Certain types of flavors, nicotine salts, and frequency of use may exacerbate these effects.
Learning from the past to protect the future
Vaping and popcorn may seem distantly related, but they are linked by exposure to inhaled compounds that are unsuitable for human respiratory systems.
To avoid repeating the mistakes of the past, it is imperative to strengthen regulations on vaping, demand greater transparency on the composition of products and intensify awareness campaigns, particularly aimed at young people.
