Experts Say Vaping Has Been Definitively Linked to Irreversible Lung Disease Called “Popcorn Lung”

23 June 2022
by: Juicing For Health
in Health, News

Last updated on

Imagine quitting smoking in hopes of reclaiming your health—only to find out that your new habit might be stealing your breath in an entirely different way. That’s the cruel irony faced by a growing number of young people and former smokers who turned to vaping, seduced by promises of safety and flavors like mango ice and bubblegum. What they didn’t expect was exposure to a disease once seen only in factory workers: popcorn lung, a rare but irreversible condition that scars the lungs’ smallest airways, making it harder—and sometimes impossible—to breathe. First identified in workers inhaling buttery flavoring chemicals at popcorn plants, this disease has found a new pathway into people’s lungs: e-cigarette vapor. While many vapes claim to be a cleaner alternative, lab tests and real-world cases suggest otherwise. In fact, some popular vape products contain diacetyl and related compounds at concentrations hundreds of times higher than occupational safety limits. So how did a disease from the factory floor become a silent threat in our pockets and school bathrooms? And why are doctors raising the alarm now, with more urgency than ever? To answer that, we need to look beyond the fruity vapor clouds—and into the chemical reality they conceal.

What Is Popcorn Lung—and Why It’s Resurfacing Now

Popcorn lung, medically known as bronchiolitis obliterans, is a progressive and incurable lung disease that damages the bronchioles—the tiniest airways deep within the lungs. These microscopic branches play a critical role in moving air in and out of the lungs. When inflamed and scarred, they narrow and harden, restricting airflow and making each breath increasingly laborious. Symptoms of popcorn lung often begin subtly—persistent coughing, shortness of breath, wheezing, fatigue—but can escalate over time to severe respiratory impairment. For some, especially those exposed over long periods or with undiagnosed progression, the disease may eventually require lung transplantation. The term “popcorn lung” first entered public awareness in the early 2000s, when several workers at a microwave popcorn plant developed this rare condition. Investigators traced the cause to diacetyl, a buttery-flavored chemical used in food manufacturing. While safe to consume in food, diacetyl becomes toxic when inhaled as an aerosol, damaging lung tissue and leaving lasting scars.
Fast-forward to today, and the disease is resurfacing—this time not in industrial settings, but among young vapers and e-cigarette users. Modern e-liquids often contain flavoring agents chemically similar to diacetyl, such as 2,3-pentanedione and acetoin, which may pose similar risks. Even more concerning is that some e-liquids labeled “diacetyl-free” have still tested positive for the compound or its equally harmful alternatives. This return of popcorn lung in a new context is not merely coincidental—it’s a public health echo. The same chemical that devastated workers’ lungs in factories is now being inhaled recreationally by teens and young adults under the guise of fruity flavors and slick branding. Unlike the popcorn plant workers, today’s vapers often have no idea they’re at risk. And in the absence of symptoms early on, damage can go unnoticed until it’s too late. What makes this resurgence especially troubling is its stealth. Popcorn lung isn’t contagious, doesn’t always show immediate signs, and once established, cannot be reversed. In a growing number of documented cases, including that of a U.S. teenager and a 29-year-old man in the UK, vaping has been implicated as the likely trigger. These are not isolated anecdotes—they’re warnings that a disease once confined to industrial environments is now emerging in homes, schools, and vape shops. Popcorn lung never truly disappeared. But vaping has given it a new—and much more pervasive—way to spread.

The Chemical Culprits in Vaping

When it comes to vaping, the seductive flavors and sleek devices often mask a far more complex—and dangerous—chemical reality. At the heart of the concern around popcorn lung is diacetyl, a buttery-flavored compound that became infamous after causing severe lung damage in microwave popcorn factory workers. But while diacetyl has become a known villain, it’s far from the only threat hiding in vape clouds. Diacetyl (2,3-butanedione) is still found in many flavored e-liquids, particularly those with dessert, custard, or creamy profiles. Inhalation of this chemical in aerosolized form causes inflammation and scarring in the bronchioles. What makes diacetyl especially dangerous is that it’s safe to ingest but toxic to inhale—a nuance often lost in product marketing. According to a 2015 Harvard University study, over 75% of sweet-flavored e-liquids tested contained diacetyl, including products that claimed to be “diacetyl-free.” Just as concerning are chemical substitutes such as 2,3-pentanedione and acetoin, which are frequently used as flavoring alternatives. These compounds have similar molecular structures and may be just as harmful when inhaled. The U.S. National Institute for Occupational Safety and Health (NIOSH) has classified both as potentially hazardous, noting that exposure can lead to severe obstructive lung disease.
And it doesn’t stop there. Vaping devices heat and aerosolize a mixture of chemicals—including propylene glycol, vegetable glycerin, nicotine, and a vast array of flavoring agents. When heated, many of these ingredients can degrade into volatile compounds such as formaldehyde and acetaldehyde, both of which are known respiratory irritants and have been linked to cellular damage in lung tissue. The inhalation route allows these chemicals to bypass the body’s natural filtration systems and enter the lungs and bloodstream almost instantly. What’s especially alarming is the lack of regulation and transparency. In independent lab tests, some e-liquids marketed as “organic” or “safe” were found to contain up to 490 times the occupational safety limits for diacetyl. Even more troubling, many manufacturers are unaware of—or do not disclose—the complete chemical makeup of their products. In an unregulated or poorly enforced market, consumers are often left trusting labels that don’t reflect reality. This chemical cocktail is especially dangerous because the interactions between compounds under heat are not fully understood. A flavoring that seems harmless on its own may become hazardous when vaporized or combined with other ingredients. In many cases, these newly formed substances have never been tested for inhalation safety. The danger, then, is not just in one rogue chemical. It’s in the entire premise of inhaling substances never meant for the lungs, especially without adequate oversight. While smoking traditional cigarettes is undeniably harmful, vaping—often marketed as a safer alternative—carries its own set of serious, and often invisible, risks. And as the evidence mounts, it’s becoming harder to ignore that what makes vaping flavorful may also be what makes it fatal.

Real Cases, Real Consequences

Take the case of Joe Adams, a 29-year-old former smoker from the UK who began vaping to improve his health. After switching to e-cigarettes, Joe believed he had made a safer choice. But when he started experiencing breathlessness and fatigue, he had no idea it was the early sign of something far more serious. By the time doctors diagnosed him with bronchiolitis obliterans, one of his lungs had collapsed. The diagnosis was grim: without a lung transplant, he had less than six months to live. Lab testing of Joe’s e-liquids revealed a cocktail of inhalation toxins—including diacetyl. Joe’s story is not an isolated tragedy. In the United States, a teenage girl who had secretly vaped for three years also developed popcorn lung. Her case was notable for the speed and severity of her symptoms—persistent coughing, extreme fatigue, and difficulty breathing. Despite being young and otherwise healthy, her lung damage was irreversible, leaving her with a lifelong respiratory disability. These personal accounts echo the 2019 EVALI outbreak (e-cigarette or vaping product use-associated lung injury), which led to over 2,800 hospitalizations and 68 deaths in the U.S. While that crisis was ultimately linked to vitamin E acetate—a thickening agent used in some cannabis vape products—it underscored the broader dangers of inhaling untested chemicals. It also demonstrated how quickly severe lung injury can develop, and how difficult it is to reverse once damage is done. Even outside of confirmed popcorn lung diagnoses, research continues to show elevated respiratory symptoms among vapers, especially adolescents. A multi-national study found that teens who vape report significantly more issues with coughing, wheezing, and shortness of breath—even when adjusting for smoking history. Certain flavor types and nicotine salt concentrations were especially associated with these symptoms. What unites these cases is not just the tragic outcome—but the sense of betrayal. Many vapers began their habit believing it was a cleaner, safer alternative to smoking. Few were warned about the inhalation risks of flavoring chemicals. And fewer still had any way of knowing that their fruity or creamy e-liquid might contain compounds never tested for safety in vaporized form.

Regulatory Gaps and Industry Accountability

In the United States, the Food and Drug Administration (FDA) does not currently require premarket testing of every chemical used in e-cigarette flavorings. While diacetyl has been recognized as hazardous in occupational settings and its inhalation risks are well-documented, it is not explicitly banned in vape products sold in the U.S. This regulatory blind spot has allowed manufacturers to use flavoring agents—some of which degrade into harmful byproducts—without standardized safety testing for inhalation. In contrast, the European Union and the UK have banned diacetyl in e-cigarettes, a move that reflects earlier lessons from the food manufacturing industry. However, enforcement remains inconsistent, and illegal or imported vape products—often available online or in informal markets—may still contain high levels of the banned substance. Independent lab tests have repeatedly uncovered e-liquids labeled “diacetyl-free” that contain the chemical in concerning concentrations. The failure to control diacetyl’s substitutes—2,3-pentanedione and acetoin, which pose similar risks—further undermines regulatory efforts. These compounds are rarely disclosed on product labels, and few regulatory bodies require manufacturers to submit full toxicological data for each ingredient. As a result, consumers are left in the dark about what they are inhaling. Compounding the problem is the self-regulated nature of the vaping industry, especially among smaller or boutique e-liquid producers. In the absence of enforceable standards, product quality and safety testing vary widely. Some responsible companies conduct independent chemical analyses and adjust formulations based on safety findings. But others have defended the use of diacetyl and its relatives, dismissing health concerns as “hysteria.” A 2014 study from the Society for Research on Nicotine and Tobacco tested e-liquids from seven countries and found that 74% of samples contained diacetyl, with nearly half exceeding the U.S. National Institute for Occupational Safety and Health (NIOSH) recommended exposure limits—some by up to 490 times. Yet many of these products were still sold freely, often under misleading claims of safety or purity. Even mainstream retailers are not immune. Popular flavors from major U.S. and UK vape brands have tested positive for alarmingly high levels of inhalation toxins. One of the best-selling custard flavors on the UK market, Beard Co.’s #51, was found to contain diacetyl at 1,843 parts per million, a level that could expose users to over 80 times the occupational safety threshold. This lack of accountability reflects a broader failure in public health messaging. In 2015, Public Health England famously claimed that vaping was “95% safer than smoking,” a statement repeated widely despite the absence of inhalation safety data for flavoring chemicals. Diacetyl and its substitutes were never mentioned in the 113-page report, nor in its follow-up publications. That omission continues to influence public perception, even as cases of vaping-related lung injuries accumulate. Regulatory agencies have not just missed opportunities to address these risks—they’ve allowed an entire generation to unknowingly inhale chemicals that would trigger safety alarms in any industrial workplace. Without mandatory ingredient disclosure, standardized testing, and meaningful enforcement, vapers are effectively testing these products on their own lungs.

Why Young People Are at Greatest Risk

Adolescents are especially vulnerable to the risks of vaping for several reasons—biological, behavioral, and environmental. First, their lungs and brains are still developing, making them more susceptible to the harmful effects of inhaled toxins. Studies have shown that early exposure to respiratory irritants can have lasting consequences on lung function and immune response, increasing the likelihood of chronic respiratory disease later in life. Second, the appeal of flavored vapes plays a pivotal role. According to data from the U.S. Centers for Disease Control and Prevention (CDC), over 85% of youth who vape report using flavored products. These flavors not only mask the harshness of inhaled chemicals but also encourage repeated use, which increases cumulative exposure to harmful substances like diacetyl and its chemical relatives. Many of these flavoring agents were designed for ingestion—not inhalation—and their safety has never been established for use in aerosolized form. Moreover, the social context of vaping—from peer influence to targeted advertising—adds fuel to the fire. Vape culture is heavily driven by online trends, social media influencers, and easily accessible products. Disposable vapes, in particular, have surged in popularity among teens due to their affordability, concealability, and lack of refillable parts. In many school environments, vaping is as routine as checking a phone—ubiquitous, discreet, and alarmingly normalized. The perception of safety is another critical factor. Because vaping is often marketed as a safer alternative to smoking, many young users don’t realize they’re inhaling chemicals that could lead to irreversible lung damage. Unlike cigarettes, which come with graphic warnings and decades of public health campaigns, vape packaging rarely conveys the full scope of risk—especially not in relation to conditions like bronchiolitis obliterans. And the data is catching up with the anecdotes. A multinational study found that adolescents who vape experience significantly higher rates of respiratory symptoms, including chronic coughing, wheezing, and breathlessness—even when accounting for their smoking history. Certain product features, such as nicotine salts and higher puff frequencies, were correlated with more severe symptoms. These findings align with real-world cases of young people developing serious lung disease, including popcorn lung, after just a few years of vaping. Unlike older smokers, many young vapers did not start with cigarettes—they began with vapes. This makes their exposure unique and possibly more insidious, as they may be inhaling higher concentrations of flavoring chemicals over longer periods, without the societal warning signs that once surrounded tobacco.

Public Health Lessons

If history has taught us anything, it’s that the cost of ignoring inhalation hazards can be steep—and tragically avoidable. The story of popcorn lung is not just a medical curiosity from the early 2000s; it is a cautionary tale about what happens when industry innovation outpaces regulation, and when seemingly small exposures accumulate into irreversible harm. The first documented outbreak of bronchiolitis obliterans among microwave popcorn factory workers should have been a wake-up call. Diacetyl, the chemical at the center of those cases, was widely used in flavoring to mimic a rich, buttery taste. It was deemed safe to eat, but the factories’ poor air ventilation and lack of protective protocols meant workers inhaled the chemical in aerosol form daily. What followed was catastrophic: healthy adults developed severe, untreatable lung damage, and one worker died. Regulatory bodies eventually stepped in. In the U.S., NIOSH and the CDC issued exposure limits and safety guidelines for diacetyl and its substitutes. The UK’s Industrial Injuries Advisory Council formally recognized bronchiolitis obliterans as a disease associated with occupational diacetyl exposure. The EU banned diacetyl in e-cigarettes as a preemptive measure. But these reforms came only after damage had already been done—and often only in response to industrial cases. Now, a similar pattern is emerging with vaping. Once again, consumers are inhaling flavored aerosols, unaware of the chemical complexity or long-term risks. Once again, early warnings from scientists and health experts are met with commercial denial, regulatory hesitation, and public confusion. And once again, it is individuals—often young and otherwise healthy—who are paying the price. The parallels are striking. The difference now is scale. Unlike factory workers limited by job exposure, today’s vapers number in the tens of millions globally, including a rapidly growing population of teenagers. The same chemicals that spurred industrial safety overhauls are now being inhaled recreationally, often with even less control or awareness. This moment offers a critical opportunity to apply the hard-won lessons of the past:
  • Chemical safety must consider route of exposure—what’s safe to eat is not necessarily safe to inhale.
  • Inhaled substances require specific testing, not assumptions based on ingestion data.
  • Transparency in product labeling and ingredient disclosure must become non-negotiable.
  • Regulation cannot wait for widespread harm before acting—especially when warning signs are already evident.
Had these principles guided the early years of the vaping industry, products containing high levels of diacetyl or its relatives might never have reached shelves. Instead, regulatory gaps allowed flavoring chemicals to bypass scrutiny, giving rise to what may become the next major public health crisis.

A Preventable Tragedy in the Making

Popcorn lung is not a theoretical threat or a relic of industrial history—it is a very real, irreversible disease that is now resurfacing through one of the most widespread habits of our time: vaping. And unlike the factory workers who were unknowingly exposed to harmful chemicals decades ago, today’s vapers are inhaling potentially toxic compounds under the illusion of safety. What makes this tragedy so painful is that it is preventable. The evidence is already here: scientific studies, documented cases, and chemical analyses all point to serious risks associated with inhaling flavoring agents like diacetyl, 2,3-pentanedione, and acetoin. These substances, when aerosolized and inhaled, have been linked to permanent lung damage—and yet, they remain present in many vape products, often without disclosure or adequate regulation. At the same time, young people—drawn in by sweet flavors, sleek designs, and the false promise of “safe smoking”—are becoming the most frequent users and, inevitably, the most vulnerable victims. Without stronger policies, clearer warnings, and a cultural shift in how we perceive vaping, these preventable cases will only continue to grow. The burden of action now lies with multiple players:
  • Regulators, who must establish and enforce stricter standards for e-liquid ingredients and labeling.
  • Manufacturers, who have a responsibility to prioritize consumer safety over flavor appeal.
  • Educators, parents, and health professionals, who can help young people understand that not all smoke-free products are harmless.
  • And consumers themselves, who deserve transparency and protection—not chemical roulette disguised as candy.
Popcorn lung doesn’t come with a warning label. Its symptoms creep in slowly, sometimes masked by what seems like a lingering cold or a little shortness of breath. But once the damage is done, it can’t be undone. The question isn’t whether we’ll look back on vaping and see the warning signs. The question is whether we’ll do something now—while we still can. Because no one should have to trade their breath for a flavor.

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