‘Vape oil doesn’t come out of my lungs’: the young man hospitalized after smoking electronic cigarettes, popular in Brazil even when banned – 08/30/2023 – Health

A smoker since he was 18, wildlife rescuer Gabriel Nogueira Souza switched from regular cigarettes to electronic cigarettes, also known as vaporizers or vapes, last year.

At the time, the 23-year-old boy had to stay in a hospital accompanying his wife, who was going to undergo spinal surgery.

“Since I couldn’t smoke in the hospital, I started using electronic cigarettes to support my addiction. It wasn’t detectable by the smoke sensor and didn’t leave a bad smell in the place”, he says.

It took him three months to vape, says Gabriel, enough time for him to suffer serious consequences.

“One day, out of the blue, I woke up coughing blood, with so much pain in my body that I couldn’t get out of bed. I thought I was going to die from so much pain in my ribs.”

Gabriel says he immediately went to the hospital, where he was hospitalized for a month.

With low saturation and shortness of breath, he underwent tests such as CT scan and X-ray. The diagnosis was ground glass in the lung, bronchopneumonia and pulmonary emphysema.

Frosted glass in itself is not a disease. It is an alteration that appears in the lung and can indicate several problems.

This alteration receives this name because it causes a stain on the lung and, on examination, the image resembles a blurred glass.

Bronchopneumonia is an inflammation of the internal structures of the lung, the bronchi and alveoli.

Finally, pulmonary emphysema is a chronic irritation where the lung alveoli are destroyed and end up losing their function, causing the patient to have a lot of difficulty breathing.

Gabriel’s treatment was done with injectable antibiotics and, according to him, it took almost 30 days before he started showing improvements.

“The doctors explained that it was not the common cigarette that caused the damage. In the exams, it was verified that inside the bronchi there was oil contained in the electronic cigarettes”, reports Gabriel.

“The problem is irreversible, because this oil has no way of getting out of my lungs.”

health risks

With attractive technological packaging and the supposed promise of being less harmful to health, the electronic cigarette, which officially receives the name of Electronic Smoking Devices (DEF), became popular mainly among young people, as well as Gabriel.

While the traditional cigarette works through the combustion of tar, nicotine and a compound of more than 40 chemical substances, the electronic ones are devices that work by a battery and different mechanisms that produce a vapor that is inhaled by the user.

Its composition varies according to the manufacturer. They also have nicotine and other liquid substances such as glycerol, vegetable glycerin, propylene glycol and flavoring agents, which are responsible for flavoring.

“All these substances can cause damage to health, such as irritation in the airways, bronchitis, bronchitis, inflammation and changes in lung function”, explained pulmonologist André Nathan, from Hospital Sírio-Libanês, to BBC News Brasil.

In addition to problems with the respiratory system, scientific studies indicate that inhaled steam can compromise the cardiovascular system and increase the risk of lung cancer and other organs.

“It causes oxidative stress, which is a cellular stress that increases the inflammatory marker and causes dysfunction of the endothelium, which are the cells that line the blood vessels internally”, adds the pulmonologist.

“This can, for example, cause a thrombosis and increases the person’s risk of a heart attack or stroke (Cerebral Vascular Accident).”

A scientific study done at Columbia University and published in the scientific journal Substance Use and Misuse found that smoking e-cigarettes increases the risk of consuming marijuana or alcohol in excess by up to 20 times.

The survey evaluated data from more than 50,000 young people between the ages of 13 and 18 who participated in the Monitoring the Future poll, applied by the National Institute on Drug Abuse in the United States.

The questions addressed nicotine consumption, both in conventional and electronic cigarettes, marijuana and alcohol.

While those young people who smoked regular cigarettes were about eight times more likely to use marijuana, vaping more than doubled that risk.

The habit of electronic cigarette smoking also multiplied by five the probability of an episode of alcohol abuse in the same period.

“For a while there was talk about the use of electronic cigarettes to reduce addiction to tobacco, which would be a containment of damage, but unfortunately this does not happen because the concentration of nicotine in it is greater and does not make you give up the addiction and even allows you to you keep jumping from one vice to another”, emphasizes Nathan.

ban in the country

A survey published this year showed that almost one in five Brazilians aged 18 to 24 have used electronic cigarettes at least once in their lives, even though the sale of this product is prohibited by the National Health Surveillance Agency (Anvisa).

The sale, importation and advertising of any electronic devices for smoking, including electronic cigarettes, are prohibited pursuant to Anvisa Resolution No. 46, of August 28, 2009.

In July last year, in a reassessment of the decision from a technical point of view, Anvisa approved the Regulatory Impact Analysis Report (AIR) on Electronic Smoking Devices (DEF).

The document maintains the ban on the sale and importation of all types of devices and recommends an increase in inspection actions to curb illegal trade and the carrying out of educational campaigns to make young people aware of the risks of using these products.

Brazil is part of a group of 32 countries that veto the vape trade, including Argentina, Mexico and India, for example.

However, at the other end of this discussion are representatives of the tobacco industry and electronic cigarette manufacturers who defend the legalization and regulation of the product in the country.

This was done in places like the United States, United Kingdom, Portugal, Italy, Japan and Canada, which released the commercialization with a greater or lesser degree of restriction.

According to a report by the World Health Organization released in 2021, 79 countries have already regulated DEFs and released the sale with supervision by regulatory bodies.

“We need to analyze that these products easily found for sale in Brazil come from the illegal market, without proof of origin and composition; therefore, they are harmful to health”, explains Giuseppe Lobo, executive manager of the Brazilian Association of the Tobacco Industry (Abifumo).

“From the moment you regulate, it will have rules for production and commercialization and will be inspected.”

Manufacturers of the devices argue that they offer reduced risk to health compared to traditional cigarettes and therefore should be released as an alternative for adult use and prohibited for adolescents, as well as ordinary cigarettes and alcoholic beverages, which cannot be sold to under 18 years old.

“Despite being prohibited, vapes are easily found, which shows that this prohibition measure does not work”, argues Lauro Anhezini Junior, director of scientific and regulatory affairs at British American Tobacco Brasil, a multinational that sells this type of product in more than 40 countries.

“For this reason, we support the idea of ​​regulating and creating rules for production, so that it will be possible to control which substances may be present in the composition and their quantity.”

Anhenzini Junior also argues that the taste of these products sold clandestinely in Brazil is one of the factors that make young people interested in the product, but that this is limited and controlled in countries where marketing is regulated.

“Today you can find tutti-futti, vanilla and others flavors that remind you of childhood. Out there, you can’t. The flavors marketed are tobacco, mint and fruit, but without being sweetened so as not to refer to a dessert”, he says.

“The regulation also makes it possible to fine anyone who sells the product to minors.”

For Corrêa, releasing the product for sale would be a setback and the country should not give in to the industry’s appeals.

“The industry wants to keep its market active. We can’t run the risk of other countries, like Canada, for example, which released the devices and today are having difficulty going back on the rules”, he says.

Jaqueline Scholz, director of the Smoking Treatment Outpatient Clinic at the Instituto do Coração (InCor), fears that the regulation could reverse the downward trend in the number of smokers in Brazil.

“Several countries accepted the arguments in favor of electronic cigarettes and released them. What happened in these places was an increase in the prevalence of smokers”, he said in a recent interview with BBC News Brasil.

“Our country had a very low smoking initiation rate among teenagers, but we see that this policy is at risk now. If we don’t address this problem now, the use of these devices is likely to become an epidemic soon.”

aftereffects of vaping

Almost ten months after leaving the hospital, Gabriel undergoes physiotherapy sessions and treatment to recover from the damage caused by vaping.

So that his situation does not get worse, Gabriel tries to maintain a healthy diet and exercise regularly to strengthen his lungs.

In addition, smoking of any type of cigarette is prohibited.

But he says that even so, he still faces several limitations on a day-to-day basis because of persistent shortness of breath.

“I have shortness of breath when I’m sleeping, which often causes me to wake up due to difficulty breathing. Last month, I was hospitalized for two days because of this problem”, he says.

“I thought that electronic cigarettes were as bad as regular cigarettes, but they are infinitely worse. I’m only 23 years old and my health was compromised because of them. If I’d known, I would never have used them.”