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Vaping Injuries Associated With Long-term Respiratory Problems, Study Finds


A new study found that patients with e-cigarette or vaping–associated lung injury had a higher risk of developing respiratory disability, cognitive impairment, symptoms of depression, anxiety, and posttraumatic stress within 1 year of their injury.

An Intermountain1 study found that patients with e-cigarette or vaping–associated lung injury (EVALI) had a higher risk of developing a respiratory disability along with a higher risk of cognitive impairment, symptoms of depression, anxiety, and posttraumatic stress within 1 year after injury.

Patients were enrolled prospectively from 2 health systems: Intermountain Healthcare and University of Utah Health. Outcomes of cognitive function, depression, anxiety, posttraumatic stress, respiratory disability, COVID-19 infection, pulmonary function, and vaping behaviors after 1 year were assessed.

There were 73 patients with EVALI who participated in this study. A 12-month follow-up period between July 20, 2020, and August 15, 2021, was observed. The patients were mostly male (66.7%) and had a mean (SD) age of 31.1 (11) years. Most patients did not need the intensive care unit (ICU) at the start of the study (59%).

After 12 months, 39% of participants had cognitive impairment and 48% reported respiratory problems. Depression and/or anxiety was reported in 59% of the participants and 64% reported posttraumatic stress. COVID-19 infections had occurred in 6.4% of participants. Many people continued to vape despite EVALI, with only 38% quitting entirely. Younger age was associated with reduced vaping behavior post-EVALI (OR, 0.93).

Participants of this study also reported the impact of EVALI on their day-to-day life and on their health care costs through the Behavioral Risk Factor Surveillance Survey Questions, which were presented at the American Thoracic Society Meeting in May 2022.

Participants reported that they were unable to work (13%); were still paying off their bills (54%); had difficulty concentrating, remembering, or making decisions due to physical, mental, or emotional condition (44%); had significant shortness of breath (24%); had difficulty dressing or bathing (16%); and continued vaping (35%), smoking (20%), and marijuana use (54%).

Denitza Blagev, MD, who was the principal investigator of the study and a pulmonary and critical care physician at Intermountain Healthcare, said that these results were alarming.

“These are not minor complications, and they are still happening even in patients whose injuries were not severe enough to require ICU care,” she said in a press2 release. “These long-term issues are also happening in relatively young people who could face a long life of continuing complications.”

She also suggested that the continued use of vaping and e-cigarette products could be a result of participants with depression, anxiety, or PTSD using those products as a way to cope.

Blagev said that raising awareness and implementing policies to reduce vaping in young people is the best way to combat these results, especially because young people have demonstrated that they were able to quit vaping more often than older people.

“And 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,” she said.

She concluded that reducing and preventing vaping in young people was the way to prevent future EVALI.


  1. Blagev DP, Callahan SJ, Harris D, et al. Prospectively assessed long-term outcomes of patients with e-cigarette or vaping-associated lung injury (EVALI). Ann Am Thorac Soc. Published online May 9, 2022. doi:10.1513/AnnalsATS.202201-049OC
  2. Intermountain study finds vaping injuries lead to. High rates of long-term respiratory problems, cognitivie impairment, anxiety, and depression. News Release. Intermountain HealthCare. June 7, 2022. Date Accessed June 9, 2022. https://intermountainhealthcare.org/news/2022/06/intermountain-study-finds-vaping-injuries-lead-to-high-rates-of-long-term-respiratory-problems-cognitive-impairment-anxiety-and-depression/
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