Electronic cigarette (e-cigarette), or vaping, product use-associated lung injury (EVALI) was first identified and reported in 2019, but media coverage and reporting of cases drastically decreased when the COVID-19 pandemic started in early 2020. The syndrome has continued to occur since that time and it is critical that pharmacists are aware of how EVALI presents, and when it should be considered as a potential diagnosis. Inpatient and outpatient pharmacists play a vital role in the treatment of EVALI, and should be knowledgeable of the utility of corticosteroids, even though data are extremely limited. Pharmacists should understand the importance of collecting detailed and accurate information about vaping from patient interviews. Pharmacists also play a leading role in cessation counseling and treatment, selecting medications that can be used to treat nicotine addiction from vaping, and assisting with transitions of care and follow-up.
KrishnasamyVPHallowellBDKoJY, et al. Update: characteristics of a nationwide outbreak of e-cigarette, or vaping, product use–associated lung injury-United States, August 2019-January 2020. MMWR Morb Mortal Wkly Rep. 2020;69:90-94. doi:10.15585/mmwr.mm6903e2
3.
CaoDJAldyKHsuS, et al. Review of health consequences of electronic cigarettes and the outbreak of electronic cigarette, or vaping, product use-associated lung injury. J Med Toxicol. 2020;16(3):295-310. doi:10.1007/s13181-020-00772-w
4.
RebuliMERoseJJNoelA, et al. The e-cigarette or vaping product use-associated lung injury epidemic: pathogenesis, management, and future directions. An official American Thoracic Society Workshop Report. Ann Am Thorac Soc. 2023;20:1-17. doi:10.1513/AnnalsATS.202209-796ST
5.
LozierMJWallaceBAndersonK, et al. Lung injury response Epidemiology/Surveillance Task Force. Update: demographic, product, and substance-use characteristics of hospitalized patients in a nationwide outbreak of e-cigarette, or vaping, product use-associated lung injuries-United States, December2019. MMWR Morb Mortal Wkly Rep. 2019;68:1142-1148. doi:10.15585/mmwr.mm6849e1
Centers for Disease Control and Prevention. ICD-10-CM Official Coding Guidelines: Supplement Coding Encounters Related to E-Cigarette, or Vaping, Product Use. Centers for Disease Control and Prevention. Published 2019. Accessed June 5, 2023. https://www.cdc.gov/nchs/data/icd/Vapingcodingguidance2019_10_17_2019.pdf
SiegelDAJatlaouiTCKoumansEH, et al. Update: interim guidance for health care providers evaluating and caring for patients with suspected e-cigarette, or vaping, product use associated lung injury—United States, October 2019. MMWR Morb Mortal Wkly Rep. 2019;68:919-927. doi:10.15585/mmwr.mm6841e3
10.
JatlaouiTCWiltzJLKabbaniSSiegelDAKoppakaRMontandonM.Update: interim guidance for health care providers for managing patients with suspected e-cigarette, or vaping, product use–associated lung injury-United States, November 2019. MMWR Morb Mortal Wkly Rep. 2019;68(46):1081-1086. doi:10.15585/mmwr.mm6846e2
11.
RoseJJKrishnan-SarinSExilVJ, et al. Cardiopulmonary impact of electronic cigarettes and vaping products: a scientific statement from the American Heart Association. Circulation. 2023;148:e1-e26. doi: 10.1161/CIR.0000000000001160
12.
BlagevDPHarrisDDunnACGuidryDWGissonCKLanspaMJ.Clinical presentation, treatment, and short-term outcomes of lung injury associated with e-cigarettes or vaping: a prospective observational cohort study. Lancet. 2019;394:2073-2083. doi:10.1016/S0140-6736(19)32679-0
13.
LaydenJEGhinaiIPrayI, et al. Pulmonary illness related to e-cigarette use in Illinois and Wisconsin—final report. N Engl J Med. 2020;382:903-916. doi:10.1056/NEJMoa1911614
14.
DavidsonKBrancatoAHeetderksP, et al. Outbreak of electronic-cigarette-associated acute lipoid pneumonia—North Carolina, July–August 2019. MMWR Morb Mortal Wkly Rep. 2019;68:784-786. doi:10.15585/mmwr.mm6836e1
15.
KalininskiyABachCTNaccaNE, et al. E-cigarette, or vaping, product use associated lung injury (EVALI): case series and diagnostic approach. Lancet Respir Med. 2019;7:1017-1026. doi:10.1016/S2213-2600(19)30415-1
16.
RiceSJHylandVBeheraMRamalingamSSBunnPBelaniCP.Guidance on the clinical management of electronic cigarette or vaping-associated lung injury. J Thorac Oncol. 2020;15(11):1727-1737. doi:10.1016/j.jtho.2020.08.012
FioreMCJaenCRBakerTB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Public Health Service, U.S. Department of Health and Human Services, 2008.
19.
HajekPPeerbuxSPhillips-WallerA, et al. Are “dual users” who smoke and use e-cigarettes interested in using varenicline to stop smoking altogether, and can they benefit from it? A cohort study of UK vapers. BMJ Open. 2019;9:e02664:1-7. doi:10.1136/bmjopen-2018-026642
20.
SchusterRMCatherCPachasGN, et al. A randomized controlled trial of varenicline and brief behavioral counseling delivered by lay counselors for adolescent vaping cessation: study protocol. Front Psychiatry. 2023;14:1083791-1083712. doi:10.3389/fpsyt.2023.1083791
21.
SahrMKelshSEBlowerN.Pharmacist assisted vape taper and behavioral support for cessation of electronic nicotine delivery system use. Clin Case Rep. 2020;8(1):100-103. doi:10.1002/ccr3.2599
22.
MikoszCADanielsonMAndersonKN, et al. Characteristics of patients experiencing rehospitalization or death after hospital discharge in a nationwide outbreak of e-cigarette, or vaping, product use-associated lung injury-United states, 2019. MMWR Morb Mortal Wkly Rep. 2019;68(5152):1183-1188. doi:10.15585/mmwr.mm685152e1
23.
TriantafyllouGATiberioPJZouRH, et al. Long-term outcomes of EVALI: a 1-year retrospective study. Lancet Respir Med. 2021;9(12):e112-e113. doi:10.1016/S2213-2600(21)00415-X
24.
BlagevDPCallahanSJHarrisD, et al. Prospectively assessed long-term outcomes of patients with e-cigarette or vaping-associated lung injury. Ann Am Thorac Soc. 2022;19(11):1892-1899. doi:10.1513/AnnalsATS.202201-049OC
