Lung injuries associated with electronic cigarette use: an integrative review




Lung injury; Vaping; Acute lung injury.


Objective: to query data on lung injuries associated with e-cigarette use. Methodology: constitutes an integrative literature review in which articles published from 2017 to 2022 were analyzed on the platforms LILACS (Latin American and Caribbean Literature in Health Sciences) and PubMed with the following descriptors “Lung injury”, “vaping” and “acute lung injury". Free articles available on the platforms published in the aforementioned period in English and Portuguese were read. In addition, articles that were dissonant with the descriptors were excluded, as well studies that were not free and those that were published outside the target date. Results: 118 studies were requested based on the descriptors, however, after applying the inclusion and exclusion criteria, only 9 articles were selected to compose the body of the present study and, then, subjected to a thorough analysis for responsible and impartial extraction of information. Conclusion: based on the texts examined, there is a clear relationship between the inhalation of vaporized substances and lung lesions and structural alterations that are capable of leading to a characteristic symptomatological condition, which may progress to the need for mechanical ventilation and death.


Aldy, K., Cao, D. J., Weaver, M. M., Rao, D., & Feng, S. Y. (2020). E-cigarette or vaping product use-associated lung injury (EVALI) features and recognition in the emergency department. Journal of the American College of Emergency Physicians open, 1(5), 1090–1096.

Almeida, L. M., Silva, R. P. D., Santos, A. T. C. D., Andrade, J. D., & Suarez, M. C. (2017). Mists, vapors and other illusory volatilities of electronic cigarettes. Névoas, vapores e outras volatilidades ilusórias dos cigarros eletrônicos. Cadernos de saude publica, 33Suppl 3(Suppl 3), e00139615.

Belok, S. H., Parikh, R., Bernardo, J., & Kathuria, H. (2020). E-cigarette, or vaping, product use-associated lung injury: a review. Pneumonia (Nathan Qld.), 12, 12.

Bertoni, N., Cavalcante, T. M., Souza, M. C., & Szklo, A. S. (2021). Prevalence of electronic nicotine delivery systems and waterpipe use in Brazil: where are we going? Revista brasileira de epidemiologia = Brazilian journal of epidemiology, 24(suppl 2), e210007.

Bhatt, J. M., Ramphul, M., & Bush, A. (2020). An update on controversies in e-cigarettes. Paediatric respiratory reviews, 36, 75–86.

Cobb, N. K., & Solanki, J. N. (2020). E-Cigarettes, Vaping Devices, and Acute Lung Injury. Respiratory care, 65(5), 713–718.

Chand, H. S., Muthumalage, T., Maziak, W., & Rahman, I. (2020). Pulmonary Toxicity and the Pathophysiology of Electronic Cigarette, or Vaping Product, Use Associated Lung Injury. Frontiers in pharmacology, 10, 1619.

Chen, J., English, S., Ogilvie, J. A., Siu, M. K. M., Tammara, A., & Haas, C. J. (2020). All up in smoke: vaping-associated lung injury. Journal of community hospital internal medicine perspectives, 10(6), 571–578.

Chidambaram, A. G., Dennis, R. A., Biko, D. M., Hook, M., Allen, J., & Rapp, J. B. (2020). Clinical and radiological characteristics of e-cigarette or vaping product use associated lung injury. Emergency radiology, 27(5), 495–501.

Dinardo, P., & Rome, E. S. (2019). Vaping: The new wave of nicotine addiction. Cleveland Clinic journal of medicine, 86(12), 789–798.

Doukas, S. G., Kavali, L., Menon, R. S., Izotov, B. N., & Bukhari, A. (2020). E-cigarette or vaping induced lung injury: A case series and literature review. Toxicology reports, 7, 1381–1386.

Fathima, S., & Zhang, H. (2020). Histologic patterns of lung injury in patients using e-cigarettes. Proceedings (Baylor University. Medical Center), 33(4), 619–620.

Hussain, A. A., Sarwar, R., & Tahir, A. (2020). E-Cigarette- or Vaping-Associated Lung Injury: An Unprecedented Enigma. The Ochsner journal, 20(1), 5.

Jankharia, B., Rajan, S., & Angirish, B. (2020). Vaping associated lung injury (EVALI) as an organizing pneumonia pattern- A case report. Lung India: official organ of Indian Chest Society, 37(6), 533–535.

King, B. A., Jones, C. M., Baldwin, G. T., & Briss, P. A. (2020). E-cigarette, or Vaping, Product Use-Associated Lung Injury: Looking Back, Moving Forward. Nicotine & tobacco research: official journal of the Society for Research on Nicotine and Tobacco, 22(Suppl 1), S96–S99.

King, B. A., Jones, C. M., Baldwin, G. T., & Briss, P. A. (2020). The EVALI and Youth Vaping Epidemics - Implications for Public Health. The New England journal of medicine, 382(8), 689–691.

Kleinman, M. T., Arechavala, R. J., Herman, D., Shi, J., Hasen, I., Ting, A., Dai, W., Carreno, J., Chavez, J., Zhao, L., & Kloner, R. A. (2020). E-cigarette or Vaping Product Use-Associated Lung Injury Produced in an Animal Model From Electronic Cigarette Vapor Exposure Without Tetrahydrocannabinol or Vitamin E Oil. Journal of the American Heart Association, 9(18), e017368.

LeBouf, R. F., Ranpara, A., Ham, J., Aldridge, M., Fernandez, E., Williams, K., Burns, D. A., & Stefaniak, A. B. (2022). Chemical Emissions From Heated Vitamin E Acetate-Insights to Respiratory Risks From Electronic Cigarette Liquid Oil Diluents Used in the Aerosolization of Δ9-THC-Containing Products. Frontiers in public health, 9, 765168.

Rice, S. J., Hyland, V., Behera, M., Ramalingam, S. S., Bunn, P., & Belani, C. P. (2020). Guidance on the Clinical Management of Electronic Cigarette or Vaping-Associated Lung Injury. Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer, 15(11), 1727–1737.

Silva, A. L. O. D., & Moreira, J. C. (2019). The ban of eletronic cigarettes in Brazil: success or failure? A proibição dos cigarros eletrônicos no Brasil: sucesso ou fracasso? Ciencia & saude coletiva, 24(8), 3013–3024.

Souza, M. T., Silva, M. D., & Carvalho, R.d (2010). Integrative review: what is it? How to do it? Einstein (Sao Paulo, Brazil), 8(1), 102–106.

Szafran, B. N., Pinkston, R., Perveen, Z., Ross, M. K., Morgan, T., Paulsen, D. B., Penn, A. L., Kaplan, B. L. F., & Noël, A. (2020). Electronic-Cigarette Vehicles and Flavoring Affect Lung Function and Immune Responses in a Murine Model. International journal of molecular sciences, 21(17), 6022.

Winnicka, L., & Shenoy, M. A. (2020). EVALI and the Pulmonary Toxicity of Electronic Cigarettes: A Review. Journal of general internal medicine, 35(7), 2130–2135.

Zulfiqar, H., Sankari, A., & Rahman, O. (2022). Vaping Associated Pulmonary Injury. In StatPearls. StatPearls Publishing.



How to Cite

MOTA, C. S. .; NUNES, G. A. S.; MATTOS, Álex B. de .; NASCIMENTO , T. H. do .; MAGALHÃES , I. G. . Lung injuries associated with electronic cigarette use: an integrative review. Research, Society and Development, [S. l.], v. 12, n. 2, p. e22012240237, 2023. DOI: 10.33448/rsd-v12i2.40237. Disponível em: Acesso em: 7 jun. 2023.



Health Sciences