Just before the pandemic took over the front, middle, and back pages of conventional and online media news, we were dealing with another major public health problem—the rise of a new disease entity recognized by the Centers for Disease Control and Prevention (CDC), e-cigarette, or vaping, product-use associated lung injury (EVALI). Given the utilization of e-cigarette and other vaping devices by teens, it would seem that EVALI could affect them as well. If so, how would it present in youth and be managed? To help us answer that question, Rao et al (10.1542/peds.2019-4104) share with us a retrospective chart review of 13 patients with confirmed or probable EVALI. The authors provide demographic information on these teens who were seen between December 2018 and November 2019, how they presented, what they were vaping, how they were managed, and information on their illness course and follow-up. It is interesting to note that while 69% of these adolescents presented with respiratory signs and symptoms, even more (85%) presented with gastrointestinal symptoms. Similar to an adult case series, more than 90% of the teens in this study self-reported vaping delta-9-tetrahydrocannabinol and 62% reported vaping nicotine products. The fact that most patients improved with glucocorticoids is important information.
To frame the importance of this article, we invited pediatric pulmonologists Drs. S. Christy Sadreameli and Peter Mogayzel from Johns Hopkins (10.1542/peds.2020-0902) to weigh in with an accompanying commentary. They point out many take-home lessons and clinical pearls contained in the Rao et al study but also remind us of our role in unraveling the psychosocial stress factors that can get teens hooked on e-cigarette and vaping products. They also highlight our role in helping teens reduce or better yet stop their vaping and suggest what we can do to advocate at a federal level to get these products out of the hands and mouths of youth under 21 years of age.
If you want to learn more about EVALI in teens and what we can do to recognize it, treat it, and ideally prevent it from ever occurring, breathe in the information from this study and commentary which is far better than having our teen patients breathe in the toxins contained in the e-cigarette and vaping products we hope they never use.
