Although vaping originally seemed like a healthier alternative to smoking cigarettes, reports of serious injuries indicate electronic cigarettes may include serious dangers of their own. An e-cigarette heats liquid to create an aerosol that the user inhales.

According to CBS Detroit, one Michigan teen experienced the hazards firsthand when his vaping injury required a double lung transplant. The emergency procedure saved his life, but his future will now include ongoing medical treatment and reduced quality of life.

The Centers for Disease Control and Prevention reports 2,711 serious or fatal cases of e-cigarette or vaping associated lung injuries, or EVALI, by mid-January of 2020. These may be the result of vitamin E acetate, which the FDA and CDC have discovered in both product samples and patient lung fluid. Researchers have not found this substance present in the lungs of people without EVALI.

Vitamin E has not proven dangerous as a supplement or topical product, and it is also present in many healthy foods. Research indicates that the only time vitamin E becomes a health hazard is when people inhale it. E-cigarettes containing tetrahydrocannabinol, or TCH, are the type most likely to also contain vitamin E.

Although the evidence seems to point to vitamin E acetate as the culprit, that does not rule out the possibility that other chemicals present in the products and lung fluid samples may play a role in causing EVALI cases. However, since the initial outbreak of cases, some manufacturers stopped including vitamin E acetate in their products, and the rate of new EVALI cases has decreased. The reduced number of cases could also be due to increased public awareness about the dangers of vaping.