Electronic Cigarettes and alternative Methods of Vaping.

Introduction:
This article provides an in-depth review of electronic cigarettes and alternative methods of vaping, focusing on the health impact of various vaping devices and the substances consumed through them. The authors aim to increase physician recognition of alternate vaping methods and devices.

Key Points:

* Vaping refers to the inhalation of heated aerosols, often containing nicotine, ThC, or flavorings.
* E-cigarettes, also known as electronic nicotine-delivery systems, are the most common vaping devices.
* E-cigarettes consist of a mouthpiece, an e-liquid chamber, a battery, and an atomizer, which transmits and converts electricity into heat to aerosolize the e-liquid.
* The design of e-cigarettes has evolved over time, with newer generations featuring adjustable atomizers, cartridges, and battery voltage for customization.
* E-liquids, also called e-juices or vape juices, typically contain nicotine, flavoring, vegetable glycerin, and polyethylene glycol. They may also contain ThC, CBD, or synthetic cannabinoids.
* Flavoring is a major motivator for vaping, particularly among youth and young adults. however, there is limited research on the health impact of exposure to these flavorings.
* Nicotine inhalation with e-cigarettes releases fewer toxic byproducts than combustible cigarettes but still raises concerns about safety.
* ThC-containing products have been associated with acute clinical conditions, such as EVaLI and cannabis hyperemesis syndrome.
* Synthetic cannabinoids, often marketed as "K2" or "Spice," may not be derived from the cannabis plant and can have unpredictable health effects.
* E-cigarette regulation in the United States has been criticized for not being comprehensive enough, with no oversight for cannabis-based products or synthetic cannabinoids labeled as "not for human consumption."

Main Message:
The text emphasizes the importance of understanding vaping practices for recognizing clinical, radiologic, and pathologic patterns of presentation, as well as the unique risks associated with each vaping method and substance. With the rise of increasingly customizable vaping devices and substances, it is crucial for healthcare professionals to stay informed about the potential risks and health effects of vaping. Furthermore, the authors suggest that a more comprehensive regulatory strategy is necessary to mitigate the risks associated with highly efficient and addictive nicotine products and easily modifiable ThC-containing products.

Choi h, Lin Y, Race E, Macmurdo MG. Electronic Cigarettes and alternative Methods of Vaping. annals of the american Thoracic Society. 2021;18(2):191-199. doi:10.1513/annalsaTS.202005-511CME