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Ingredients In E-Cigarettes: What We Know And Don't Know

The region including Dallas-Fort Worth has reported about 22 cases of lung injury believed to be related to vaping.

The CDC currently estimates more than 1,000 cases of lung-related illnesses across the country related to e-cigarettes. The cases have developed over years, and doctors have learned a lot over that time about vaping. But one pulmonologist worries about what we still don’t know.

Dr. Mark Millard with Baylor Foster Lung Care Center in Dallas says the first case in the Dallas-Fort Worth area appeared three or four years ago. It was a young man brought to the emergency room who ultimately died of an acute lung injury.

“And the only thing that could be found was that he was vaping something that he had bought from a mom-and-pop operation, or vaping shop, out in the Mid Cities,” Millard said.

The doctor who cared for him was convinced there was something in the vaping substance itself. But the ingredients were the secret of the shop that’s believed to have gone out of business.  

Dr. Millard says what is known today about ingredients in e-cigarettes is reason for worry.


Two dangerous e-cigarette ingredients: “There are a number of substances — the popcorn flavoring diacetyl can cause lung injury. You can have safe ingredients. For example, propylene glycol is the diluent in many of the commerically available e-cigarettes.”

Diluent? “The diluent it's packaged with, it's dissolved in. The nicotine is dissolved in propylene glycol. At low voltages, that's probably relatively innocuous. But as we've gotten more sophisticated, moved to second- and third-generation devices, as the voltage has increased, what we've seen is propylene glycol actually turns into formaldehyde at really high temperatures. And so if you've got it dialed up to high, you're in trouble and even the simple vegetable oils at the same thing they turn into acetaldehyde.”

What worries you most about vaping? “We have no clue what the long-term risks of vaping are. We do know that the respiratory system has never seen this before. We haven't had time to figure out what this does to the surface lining of the lungs. It's not just the e-cigarette. If it were only the e-cigarette, you can argue it's probably safer to use an e-cigarette than a pack a day of tobacco. But beyond that when you start putting stuff that you can find off the drugstore shelf because it might taste good or it might smell good or it might make you feel good, or buy off the street, we have no clue what we're getting into.”


CDC: Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping

Inhale this: Why vaping is destroying Your lungs

54 vaping-related illnesses reported in Texas

Popcorn Lung: A Dangerous Risk of Flavored E-Cigarettes

Sam Baker is KERA's senior editor and local host for Morning Edition. The native of Beaumont, Texas, also edits and produces radio commentaries and Vital Signs, a series that's part of the station's Breakthroughs initiative. He also was the longtime host of KERA 13’s Emmy Award-winning public affairs program On the Record. He also won an Emmy in 2008 for KERA’s Sharing the Power: A Voter’s Voice Special, and has earned honors from the Associated Press and the Public Radio News Directors Inc.