What is the difference between vaping and ordinary cigarette smoking? I’m Dr. Mary Clifton. I’m an internal medicine doctor and an expert in CBD, THC, and other cannabinoids.



What’s the difference between vaping and cigarette smoking?

How do people look when they’re sick with vape related Illness?

How prevalent are toxic chemicals in vaping products?

Overall, six Americans have died due to vaping-related illnesses, and 500 have been seriously sickened. This has led to the CDC and the American Medical Association recommending that the 11 million Americans that are routinely vaping quit immediately. There are questions about exactly why people are getting sick. It may be predisposition in the patient that they have some sort of underlying disease that’s causing a higher risk of getting sick. It may be that the devices they were using were faulty, or it may be that after manufacturing, the vaping product was somehow contaminated or modified, and that led to significant lung damage.

There are specific products found in vapes that are not found in tobacco cigarettes, and they may be the culprit for the problem with the lung disease.Tweet this

Vapes were initially brought to America with the intent to help tobacco users quit smoking, but they weren’t particularly effective. And in fact, it’s thought that many of the fruit and cocktail flavorings attracting a lot of young people to vaping and led to a much higher rate of tobacco addiction. They don’t appear to have great data around tobacco cessation.

So vaping has taken off dramatically, but there are specifics to vapes that are different than cigarettes. And when vaping was first introduced to the United States and its safety was assessed, it was assessed based on known toxicities and known negative health outcomes associated with cigarettes but vapes have products in them that you don’t see in cigarettes. The vehicle that the products are contained in, that the formulations are contained in often contain vegetable glycerin and propylene glycol, which are not contained in tobacco cigarettes and there is oftentimes flavorings which are food-safe, but that doesn’t necessarily mean that they’re inhalation-safe.

In fact, one flavoring that is widely used throughout the vape industry; diacetyl is known to cause irreversible lung disease in workers who have occupational exposure. It’s also known to increase asthma problems in people who have asthma. Not only are the food flavorings a problem, but the e-cigarettes also have the propylene glycol and vegetable glycerin, which are additional products from the petroleum industry and sugars that can break down into harmful carbonyls and also break down products from sugars like formaldehyde, acetaldehyde, and acrolein.

One of the main ways that tobacco smoke appears to cause lung damage is through the activation of proteases.Tweet this

Proteases are enzymes in the lungs that break down proteins. So if you, on accident, breathe in a foreign body, the proteases can go and break it down, and clean it up, and get it out of the lung. But in the setting of chronic inflammation from smoking or it turns out from vaping also; the proteases can activate and sometimes activate against the lung tissue itself. So instead of the lungs being all kinds of tiny air sacs with very thin membranes that are excellent at diffusing oxygen and carbon dioxide, the air sacs start to coalesce and become more like several small balloons, which are not as effective at transporting oxygen and carbon dioxide. That’s the development of emphysema. That’s what emphysema looks like on chest X-ray or when we do lung biopsies on emphysematous patients.

In fact, scientists have done washings of the bronchial tree, where they’ve literally squirted saline into people’s lungs and then suctioned it back out in test areas to try to see what’s going on with protease levels and it turns out that the proteases MM2 and MM9 are identified in the bronchial washings of patients who are vaping at higher levels than you would expect.

It doesn’t appear that vaping is any safer than cigarette smoking as it relates to proteases and vaping may not be any safer than cigarettes on any measure. But what’s the story behind people that vape and get sick? What does that illness look like? To hear more about this as I present some case reports on this matter, click here.

About the Author


Dr. Mary Clifton is an Internal Medicine doctor with 20 years of experience in both the hospital and private practice. She is a published researcher, national speaker on women’s health and osteoporosis, and author of four books, and two new soon-to-be-released books on CBD and Cannabis – what you need to know, how to use them and a COOKBOOK to support ease of use.