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SALT LAKE CITY — Lung injuries from e-cigarettes or vaping can lead to long-term issues including respiratory problems, cognitive impairment and mental health issues, according to an Intermountain Healthcare study.
The study was accepted into the Annals of the American Thoracic Society in May, after being submitted in January. It found that long-term impacts of e-cigarette or vaping associated lung injury (EVALI) can persist for a year or more.
"Even at 12 months after an EVALI diagnosis, the majority of our patients still had serious residual effects," Dr. Denitza Blagev, principal investigator of the study, said.
Blagev, a pulmonary and critical care physician at Intermountain, said most patients in the study did not have significant comorbidities when they were diagnosed, so seeing serious issues after a year was concerning.
The study followed 73 EVALI patients treated at either Intermountain Healthcare or University of Utah Health who had a 12-month follow-up appointment between July 2020 and August 2021. Patients involved in the study were mostly male and an average of about 31 years old.
At a 12-month follow-up appointment, 48% of the patients had respiratory issues and about one-fourth reported significant shortness of breath. They were also diagnosed with mental health issues — 59% had anxiety, depression, or both, and 62% had experienced post-traumatic stress.
In a self-reporting survey, 13% of the patients said they were not able to work, 16% reported difficulty dressing or bathing, 54% were still paying medical bills and 44% reported mental difficulties including concentrating, remembering and making decisions.
"These are not minor complications, and they are still happening even in patients whose injuries were not severe enough to require (intensive) care," Blagev said. "These long-term issues are also happening in relatively young people who could face a long life of continuing complications."
The study also found that 62% of patients continued to smoke, despite the continuing physical impact that vaping or smoking had on their health. Over half reported using marijuana, 35% reported vaping or using e-cigarettes and 20% reported smoking.
Blagev said that the statistics are alarming, but the high rate of vaping and tobacco use after diagnosis is not surprising.
"It's not for a lack of motivation or a lack of understanding how severe this could still be, especially for patients that have depression, anxiety and PTSD, and who might be reaching for those vaping behaviors to cope," she said.
However, she said participants who did quit were younger, which shows the importance of targeted outreach. Blagev said interventions should include raising awareness, as well as more policies to reduce vaping and mental health issues in youth.
"We need to better address mental health issues among young people so that they have more help than self-medicating with vaping and marijuana use," Blagev said.
The Intermountain Healthcare study also cited the National Youth Tobacco Survey which shows that e-cigarette use in teenagers is rising, with 11.3% of high school students and 2.8% of middle school students reporting vaping use in the last month.