Relationship between electronic cigarette use and the development of lung lesions

Abstract

E-cigarette use has increased globally, particularly among adolescents and young adults, often perceived as a safer alternative to conventional tobacco. However, recent scientific evidence links vaping to acute lung injuries such as EVALI (E-cigarette or Vaping Product Use–Associated Lung Injury) and chronic respiratory symptoms. This study presents a qualitative systematic review of literature published between 2019 and 2025 from databases including PubMed, Scopus, Web of Science, Google Scholar, and SciELO. Key toxic compounds—vitamin E acetate, nicotine, propylene glycol, and vegetable glycerin—were identified as drivers of diffuse alveolar damage, chronic inflammation, and oxidative stress. Findings confirm that vaping is not harmless; rather, it constitutes an emerging risk factor for respiratory health with both acute and chronic consequences. The study concludes that stricter regulations, targeted educational campaigns for vulnerable populations, and standardized clinical protocols for early detection and management of vaping-induced lung injuries are urgently needed.