Popcorn lung to some people might be an old wife’s tale (not that this story is old), yet the truth is backed up with solid hard evidence. The real juice lies within real life case studies/incidents that are occurring more often with higher severity. Although vaping is not the only bad guy to blame. Stay with me as we uncover abundant nail-biting stories and facts in popcorn long | myth or reality blog.
Before we begin
What is popcorn lung technically? Popcorn lung is bronchiolitis obliterans, tiny air tubes in your lungs called bronchioles, think of them like the branches on a tree that carry air all the way to the leaves (your air sacs). When they get damaged by foreign chemicals rather severely, the body immediately tries to heal them.
This healing process is rather rough and fast, leaving behind scar tissue. Those scars narrow and block the bronchioles, which is the serious problem. This damage is permanent, no cure, no long-term healing, you are just damaged for life. Causing wheezing, shortness of breath and dry coughs. Treatments can ease symptoms and that’s as far as it goes.
Real Life Cases
17-year-old high-school cheerleader (Brianne Cullen, Nevada)
Secretly vaped for around 3 years, started at the age of 14. presented with severe breathing difficulty during cheerleading practice. Diagnosed with bronchiolitis obliterans (“popcorn lung”). Sadly, this was a chronic and irreversible case, she now needs inhalers, risk for long-term degradation is a reality even if managed well. Here is the source for more details.
Vaping-associated Constrictive Bronchiolitis in a Woman in Her 40s
No name is given for privacy reasons, yet all the evidence is there. She was a regular daily vape (with no confirmed consumption amount) for several years before she started to get symptoms. With no other history of lung disease over working with heavy chemicals, the culprit was obvious.
She developed rapid onset, shortness of breath and cough. Pulmonary function tests showed severe obstruction and importantly no substantial response to bronchodilators. (That means intense inhalers weren’t doing much.) A CT scan of her chest showed extensive air trapping. (Air trapping = air gets stuck in the small airways, one of the hallmarks of bronchiolitis obliterans.)
So, they did a lung cryobiopsy (a biopsy of lung tissue) after other causes had been ruled out, and they saw airway inflammation and prominent bronchial-associated lymphoid tissue. Basically, they did all the tests, and she came out positive for popcorn lung.
Notes of this Case: This is a highly unique case as there is abundant evidence in all the tests done on her. Most people will never have these tests done since lack of funds, tools, time, doctors and many other reasons. So, there are a lot of other cases like this out there, there just isn’t the evidence.
17-year-old in Canada, intensive vaping of flavored e-cigarettes + THC
In this case we can immediately see there are other contributing factors to the lung damage other than vape fluid, THC is also involved. After months of daily heavy vaping, they developed cough, fever, breathing trouble and they were hospitalized. Doctors said case it looked more like popcorn lung than anything else.
Near-fatal risk, serious inflammation, lung damage and they weren’t sure of the full long‐term outcome. Here are the sources for this case.
How Does This Happen: The Real Science
A we mentioned above: What is bronchiolitis obliterans (“popcorn lung”)?
Scarring/fibrosis of the small airways (bronchioles), narrowing, obstruction of airflow. Once scarred, damage is largely irreversible. Here are the culprits though:
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The culprit chemical: diacetyl
Proven in industrial settings (popcorn factory workers, flavoring factories) to cause this when inhaled chronically. Hence where the name comes from. A super fascinating fact. -
Vaping liquids and diacetyl
Some e-liquids/flavorings have been found to contain diacetyl (or compounds that are structurally similar or degrade into harmful byproducts) especially in unregulated. The good news is that many regulated markets have bans/restrictions on diacetyl in e-liquids. -
Other possible chemicals
Beyond diacetyl: acetaldehyde, formaldehyde, ultrafine particles, flavoring additives, solvents that may, with heat or poor regulation, produce harmful byproducts. Stripping your bronchioles causing them to heal and scar. -
Dose, duration, and heat matter:
Higher power, low quality device, long exposure means more risk. Frequency, flavoring strength, and how the user vapes (deep inhalation, etc.) affect exposure. Some lab studies show that carbonyl compounds spike when devices overheat. This shows that those with more powerful devices like mods are more prone to this horrendous fate. -
Biological process: injury to bronchioles leads to inflammation causing healing with fibrous scar tissue resulting in narrowing/obliteration of airway lumen which equals reduced airflow, shortness of breath, wheezing, cough. Over time can lead to respiratory failure.
How to Avoid Popcorn Lung
Other than the obvious solutions towards the issue (quitting) here are some good ways to avoid this rather serious conundrum.
Avoid flavored e-liquids with diacetyl or untested flavorings: Check lab tests or certifications on the products you’re currently using or intend on trying. There is no harm in a little research to save your long-term health.
Use regulated products: Devices and liquids from reputable manufacturers, markets with oversight. The more popular a brand often means they passed most of the tests. Allowing them to sell to further reaches.
Avoid modifying or mixing unknown chemicals: Don’t DIY, don’t use black-market vape or additives. We used to make our own vape liquids in our chemistry lab at school. This is a good example of what not to do.
Don’t vape intensively: Limit exposure: frequency, depth of inhale, avoid high power settings. This is the golden rule, don’t vape like your life depends on it. Smoke rarely and softly, decreasing your risk. Cloud chasing isn’t cool, it’s crazy dangerous.
Monitor symptoms: Especially if you vape persistently and are coughing, wheezing struggling with shortness of breath and it’s not explained by other causes. Go and seek medical help.
Why Some Think It’s a Myth
Popcorn lung is incredibly rare and doesn’t happen to everyone, even if they are exposed to dangerous chemicals or smoke rigorously. The lack of evidence in large populations is also a contributing factor, especially when there are so many people who smoke vapes all day for many years and don’t have any sever underlying issues.
Some countries have banned diacetyl so the risk of getting popcorn lung is considerably diminished. There can also be a lot of confusion between media and hard evidence from doctors as to the exact causes of some lung damaged cases. Many people also don’t get the chance to go to the doctors if they can’t afford it and think their symptoms are minor (they just live with it).
Conclusion
Popcorn lung is real. It’s a serious, irreversible lung disease that has been documented in industrial settings and some recent vaping cases. That said, the evidence that vaping commonly causes popcorn lung is weak, the cases are rare and often caused by long use of unregulated products.
The risk isn’t zero especially for young people, flavor lovers, heavy users, or those using unregulated products. Best approach is to treat it as a real possibility. Avoid unnecessary risks, push for better regulation, and advocate good awareness.
