As a comparatively new lifestyle choice, vaping often faces questions about health and safety. The dangers of smoking cigarettes have been well documented for decades. Vaping devices, however, still primarily operate in a realm of anxious theory.
Among the most prominent health concerns connected to vaping
is so-called Popcorn Lung. A handful of young people across the United States
and Canada were hospitalised with lung complaints throughout 2019.
The one thing these patients had in common was that they all
owned and utilised e-cigarettes. Naturally, this led to a range of assumptions.
The question remains, however – can vaping cause popcorn lung?
What is Popcorn Lung?
Popcorn lung is the colloquial term for the medical
condition bronchiolitis obliterans, or obliterative bronchiolitis.
Popcorn lung impacts the bronchioles, which are tiny airways
located within the lungs. The condition causes inflammation within the
bronchioles, which in turn leads to scar tissue forming on the lungs. This
restricts airflow, which will have a significant impact on the respiratory
What Causes Popcorn Lung?
The name ‘popcorn lung’ stems from the agent believed to
cause the issue – diacetyl. Diacetyl is a chemical compound a strong
This means that diacetyl is frequently used as a sweetening
agent in food and drink. The most common example of this is microwave popcorn.
Diacetyl provides this product with its unmistakable scent and taste.
Unfortunately, diacetyl is as dangerous as it is delicious.
The journal Toxicological
Sciences confirms that inhaling this chemical is what causes inflammation
within the bronchioles. In addition, two other compounds are considered equally
The most prominent of these is acetoin. Acetoin is often
linked to diacetyl, due to the compound’s buttery aroma. This connection
stretches further, too. Explained by the journal Food
and Chemical Toxicology, traces of acetoin can generate diacetyl. Acetoin
must be not be inhaled.
The third point of this triangle of danger is acetylpropionyl.
This compound is often used to create a buttery or caramel flavour in foods.
It’s also found in some solvent products. Inhaling acetylpropionyl is every bit
as dangerous as acetoin or diacetyl.
If Diacetyl is Dangerous, Why is it Legal?
It isn’t. Diacetyl is a banned
substance in e-liquids for vapes and e-cigarettes under the EU law. Any vape
juice sold in the UK – including anything you will find within the Mist e-shop
– is diacetyl-free. This means that we can answer the question of whether
vaping causes popcorn lung with a solid, “no” – provided consumers vape safely
The FDA has yet to formalise a ban across the Atlantic
however, which presumably explains the number of cases of popcorn lung attached
to vaping in the USA. Diacetyl has been
declared safe for ingestion by the FDA, but as of yet no policy has been struck
Several states have taken to banning flavoured e-liquids as
a precaution, concerned that diagnoses will continue to build – especially
among young vapers, who are attracted to unique flavours. While this concern is
admirable, it’s akin to cracking the shell of a walnut with a sledgehammer.
Popcorn lung and vape juice are not intrinsically linked, in
the way that tobacco is accompanied by the unavoidable risk of lung cancer. It
is possible to vape safely, if e-liquid ingredients are sourced and chosen
If you buy from a licensed trader, your e-liquid will be
rested and approved by the Medicines & Healthcare products Regulatory
Agency (MHRA) and will be devoid of harmful ingredients. A private seller may
not be able to offer the same assurances.
How Many People Have Developed Popcorn Lung from Vaping?
As vaping is still so new, it is impossible to answer this question with scientific accuracy. A handful of cases of a popcorn lung have been attributed to vaping. This is based on theory and speculation, however. It will be a number of years before enough data has been collated to form a solid scientific opinion.
It should also be stressed that all cases of suspected popcorn lung cases connected to vaping have originated in the United States and Canada. Remember – in these locations, diacetyl remains a legal ingredient in vape juice. This has led to a public health concern, dubbed vaping lung disease.
These concerns were magnified by a study published by the
Health Perspectives back in 2015. This study made the accusation that
popcorn lung and vaping are interconnected. This was based on studying the
ingredients of 51 different e-juices, finding that 39 of them contained
diacetyl. When testing for acetoin and acetylpropionyl too, this number rose to
The study has been dubbed as misleading and inconclusive
however, as there is no evidence that popcorn lung can be caused exclusively by
vaping. The quantities of ingestion required remain a mystery, and there are a
multitude of manners in which somebody could inhale dangerous chemicals.
Individuals working in an industrial factory setting are particularly at risk.
Health Perspectives has since doubled down on their claims, publishing a
follow-up article in 2019 that continues to connect e-liquid with lung disease.
Again, however, these concerns are based around to chemicals and ingredients
that are not permitted in the UK.
What are the Symptoms of Popcorn Lung?
Popcorn lung restricts the airways, making it harder to
bringing oxygen into the body. This will lead to a dry, rattling cough, which
will likely steadily grow worse over a period of weeks and months.
In addition to a cough, many popcorn lung patients complain
about shortness of breath. Physical activity will magnify this. It is normal to
feel out of breath after running or jogging. Somebody with popcorn lung will
find this happening over increasingly short distances, however. Eventually,
such rudimentary tasks as walking up the stairs will leave a patient
Inhaling diacetyl can also lead to a stinging sensation
around the eyes and throat. If a vaping liquid provokes this response, you
should cease using the e-cigarette immediately. Other, additional symptoms to
look out for include:
- Fever and high temperatures.
- Sudden and inexplicable weight loss.
- Night sweats.
Now, do not panic if you are experiencing any of these
symptoms. There are comparatively common and could point to any number of
different diagnoses. Asthma or COPD are most likely explanations.
Speak to a healthcare professional. A handful of lifestyle
changes and steroidal medications may resolve your symptoms. If this is not the
case, you will likely to referred to a hospital-based specialist.
Diagnosis of popcorn lung involves a long and varied
sequence of tests. X-rays, CT scans and even exploratory keyhole surgery may
all be required before the condition can be confirmed.
How Can I Protect Myself from Popcorn Lung?
As discussed, it is important to always purchase e-liquid
from a reputable brand and supplier. Never purchase your vape juice from an unregistered
seller, or a shopfront that displays questionable behaviours (such as selling
e-liquid to minors or removing labels.)
If you avoid these chemicals, and vape responsibly, you can
relax. The threat of popcorn lung will not loom large over you. As per the
review of e-cigarettes, vaping and popcorn lung are not frequently linked.