New Zealand Researcher Claims that Using E-Cigarettes Coats the Lungs With Oil

An electronic cigarette researcher from Auckland University's Bio Engineering Institute is telling the public that when people use e-cigarettes, their lungs become coated with oil, leading to inflammation that eventually causes lung disease.

According to an article in RNZ, the professor is quoted as stating:

"Every time you vape, some of that will stay inside your lungs, so the e-liquids that are in vapes are sort of quite an oily substance. There'll be a lining of this oil that will stay inside your lungs and actually one of the things that is designed to get rid of that is the process of inflammation. It's when you have this inflammation occurring many times a day over many years, which is what leads to disease and tissue breakdown."

The Rest of the Story

Most, if not all, electronic cigarettes contain either propylene glycol or glycerin (or both) as the excipient in their e-liquids. This researcher is claiming that propylene glycol and glycerin, when inhaled, will coat the lungs with oil, triggering an inflammatory response that eventually will lead to chronic lung disease.

The problem with this claim is that neither propylene glycol nor glycerin is or contains any oil. Both are in fact water-soluble or water-miscible substances that are water-based, so they don't coat the airways of the lung with oil. Propylene glycol is in fact an alcohol, not an oil. Glycerin is also an alcohol (technically a polyol, or "sugar" alcohol), not an oil. So to dispel the false claims out there, using e-cigarettes is not going to coat your lungs with oil. There is no oil in virtually all, if not all, e-liquids. And if anyone finds an e-liquid with essential oils in it then they should report it immediately so that it can be taken off the market.

Perhaps the researcher's confusion is that propylene glycol and glycerin can be derived from oils. But neither of them is an oil.

The only danger of having your lungs coated with oil from vaping is if you vape THC vape carts that you bought off the black market that contain vitamin E acetate, which is an oil. This is what led to the inaptly named EVALI scare in 2019. However, black market producers of THC vape carts have largely, if not completely, stopped using vitamin E acetate as a thickening agent. I would still recommend that everyone avoid purchasing THC vape carts off the black market because of the possibility that there are still some errant warehouses where vitamin E acetate may be used. But you are not going to develop "EVALI" if you stick to retail-purchased electronic cigarettes.  

For some reason, most health departments, health organizations, tobacco control organizations, and tobacco control researchers are intentionally lumping e-cigarettes in with THC vapes as a cause of EVALI when there is no evidence that any e-cigarettes played a role. Although I could perhaps understand this in the summer of 2019 when it was not entirely clear what was causing EVALI, this is inexcusable five years later when we know that EVALI was caused by vitamin E acetate in THC vape carts. It is also inexcusable since neither propylene glycol nor glycerin are oils in the first place.

Nevertheless, even reputable health organizations continue to spread this misinformation. For example, Johns Hopkins Medicine still claims on its web site that vaping causes lipoid pneumonia. The claim: "Unlike the classic pneumonia caused by infection, lipoid pneumonia develops when fatty acids (the building blocks of fat) enter the lungs. Vaping-related lipoid pneumonia is the result of inhaling oily substances found in e-liquid, which sparks an inflammatory response in the lungs. ... The single-most important thing you can do is identify what is causing it — in this case vaping — and eliminate it."

As another example, Baystate Health states: "Much of the concern about vaping revolves around vape juice. Hart explains, “Vitamin E is frequently used as the base for vape juice. People hear ‘vitamin’ and assume it’s safe. And while Vitamin E is safe when taken as an oral supplement or even in lotions, it’s not really meant to be heated and inhaled and has been found in the lungs of people with severe, vaping-related damage." While the last two sentences are accurate, the first two are very misleading. Vitamin E is never used as the base for vape juice. In 2019, it served as an "additive" specifically for many black market THC vape carts, but it has never been used in e-liquids for nicotine-based e-cigarettes. 

Houston Methodist makes a similar claim to that of Johns Hopkins: "Unlike classic pneumonia, which is caused by infection, lipoid pneumonia develops when fatty acids enter the lungs. The liquids used in vaping products contain oily substances, which, when inhaled, can spark an inflammatory response in the lungs."

The problem with all three of these statements, as well as the hundreds of similar ones being made by many health and tobacco control groups, is that they lump e-cigarettes in with THC vapes. They are all talking about potential harms of "vaping." This is not very helpful if you're really committed to keeping young people alive and free of severe acute respiratory distress. Most youth are not going to stop vaping completely. However, if you can direct them away from the truly hazardous products, then you are giving them a feasible path to safety. We should have been specifically warning youth about the dangers of vaping black market THC carts, not condemning all vaping (even e-cigarettes) as potentially leading to fatal respiratory disease.

Is the American Cancer Society Really Interested in Preventing Cancer or Just Punishing Smokers Who Don't Use Cessation Products Made by ACS Donors?

Product A is a flavored product that appeals to youth and has rapidly gained in popularity among youth.

Product B is a flavored product that appeals to youth and has rapidly gained in popularity among youth.

Product A is largely manufactured by companies that have a history of marketing to youth.

Product B is largely manufactured by companies that have a history of marketing to youth.

Product A is potentially addictive.

Product B is potentially addictive.

Product A is thought to entice youth to use the product because of its appealing flavor varieties.

Product B is thought to entice youth to use the product because of its appealing flavor varieties.

Product A is not known to have caused any deaths among youths nor has it been linked to chronic disease.

Product B causes thousands of youth deaths each year and is known to cause chronic disease, including cancer.

Product A is being used by millions of adults to immediately improve their health and essentially save their lives.

Product B causes cancer even at low doses and does not have any overall health benefits.

The Rest of the Story

The American Cancer Society is lobbying aggressively for a complete ban on Product A.

The American Cancer Society seems perfectly content to let Product B stay on the market, essentially unregulated. It is not promoting a ban on Product B or even strict regulation of marketing for Product B, even though it is a leading cause of cancer in the United States.

If you haven't guessed yet, Product A is flavored electronic cigarettes.

Product B is flavored alcoholic beverages.

The American Cancer Society is calling for a ban on flavored e-cigarettes based on the premise that if a potentially harmful product uses flavors that appeal to youth, it should be taken off the market. However, they are not calling for a similar ban on flavored alcoholic beverages even though these products use flavors that appeal to youth and are far more harmful than nicotine vapes.

While its website is chock full of advocacy efforts to eliminate flavored e-cigarettes, I am unable to find a single mention of any similar effort to prohibit or even just to regulate flavored alcoholic beverages.

This inconsistency raises the question of why? Why should alcohol companies be allowed to market flavored alcoholic beverages to underage youth and why should these products remain on the market essentially unregulated while flavored vapes are completely banned?

Presumably, the American Cancer Society is not pushing for a ban on flavored alcoholic beverages because it understand the need for these products to remain on the market because they are also used by many adults. Then why is it pushing for a ban on flavored e-cigarettes even though they, too, are used by many adults? If anything, it would make more sense to ban flavored alcoholic beverages because they do not have any health benefits for adults but cause thousands of deaths every year.

This suggests that somehow, the American Cancer Society values adults who are potentially harming their health by drinking more than it values adults who are undoubtedly improving their health by switching from smoking to vaping. To promote a ban on flavored e-cigarettes, you really have to be OK with punishing smokers who use e-cigarettes as a cessation tool. If you are really trying to prevent cancer, it should be more important to address the enormous problem of the use of flavored alcohol products among underage drinkers--a product that has been demonstrated to be a starter drink that leads to heavier alcohol consumption, a cause of thousands of cancer deaths each year--than to ban flavored vapes that have been demonstrated to lead to decreases in youth smoking rates and for which there is no evidence that it causes cancer.

On the other hand, the American Cancer Society is perfectly OK with smokers quitting by using medications (like varenicline) that are manufactured by pharmaceutical companies which have donated huge amounts of money to them.

Campaign for Tobacco-Free Kids Falsely Claims that Vaping is "Tobacco Use"

In its Take Down Tobacco program, the Campaign for Tobacco-Free Kids is lamenting the fact that through its sale of flavored vapes, the tobacco industry is addicting youth and reversing progress in reducing tobacco use. 

The Campaign for Tobacco-Free Kids states that: "Flavored vapes have fueled the youth e-cigarette epidemic, which is addicting a generation of kids and threatening to reverse decades of progress to reduce youth tobacco use in the U.S." 

They also claim that: "Eliminating the sale of flavored e-cigarettes is a critical step toward ending the tobacco industry’s modern day pipeline of youth addiction."

The Rest of the Story

The Campaign for Tobacco-Free Kids is being disingenuous in claiming that youth who vape are using tobacco. They are doing nothing of the sort. They may be inhaling nicotine, but they are not using tobacco. Perhaps the Campaign is not aware of this, but vapes do not contain any tobacco. Thus, it is inaccurate and irresponsibly misleading to publicly state that vaping is a form of tobacco use.

I don't believe for a moment that the Campaign for Tobacco-Free Kids is not aware that vapes do not contain tobacco. I believe, instead, that they are deliberately making false statements in order to advance their goal of eliminating these products from the market. While youth vaping should be discouraged, it is completely disingenuous to tell kids who are vaping that they are using tobacco. I support campaigns to try to prevent youth e-cigarette use, but I do not support lying to kids in order to achieve this goal.

I also have to question the validity of the claim that tobacco companies are currently marketing flavored vapes (other than tobacco and menthol-flavored products). The FDA has only authorized tobacco or menthol vapes produced by tobacco companies. I'm not aware that they are defying the law by selling other non-authorized flavors as the Campaign for Tobacco-Free Kids seems to be claiming.

For decades, we attacked the tobacco companies for lying to the American people about tobacco use. Ironically, we are now the ones who are lying about tobacco use. And we're getting away with it because the tobacco companies are no longer challenging anything we say. 

As I've stated before, I don't believe that the ends justify the means. In public health, transparency and honesty are core values. We are not justified in pursuing the end of preventing youth vaping by using the means of lying to youth and to the general public. This dishonesty has got to end. 

My Testimony Before the Rhode Island Senate Finance Committee on S543 - A Bill to Allow the Sale of Electronic Cigarettes at Adult-only Vape Shops

I had the pleasure yesterday of testifying before the Rhode Island Senate Finance Committee on bill S543, introduced by Senator DiPalma, which would create an exemption in the state's current an on the sale of flavored e-cigarettes to allow the sale of these products at adult-only (21+) vape shops. Here is my written testimony:

Written Testimony of Michael Siegel, MD, MPH on Bill S543

Allowing Vape Shops to Sell Flavored E-Cigarettes

Professor, Tufts University School of Medicine

March 30, 2025

Dear Members of the Senate Finance Committee:

I am a physician and a professor in the Department of Public Health and Community Medicine at the Tufts University School of Medicine. For the past 35 years, I have been a tobacco control researcher and anti-tobacco advocate. I played a major role in lobbying across the United States for 100% smoke-free bar and restaurant regulations. In fact, as a student at Brown University, I wrote and lobbied for the first smoke-free workplace law in Rhode Island, which the legislature enacted in 1986. I have also testified as an expert witness for plaintiffs in eight different lawsuits against the tobacco industry, including the infamous Engle case which resulted in an unprecedented $145 billion verdict against the cigarette companies. I have published nearly 100 peer-reviewed journal articles relating to smoking and tobacco use. In short, I am a long-time, committed anti-tobacco researcher and advocate.

Today, I want to call your attention to one particular age group of Rhode Island residents who are using flavored e-cigarettes in record numbers. In fact, the use of flavored e-cigarettes and vaping products is running rampant among this age group throughout the country. A recent survey of this age group revealed that 71% of those who vape prefer flavored e-cigarettes, including 61% who use fruit, candy, sweets, chocolate, clove, spice, herb, or alcohol flavors.[1] I estimate that approximately 50,000 Rhode Island residents in this age group were using flavored e-cigarettes prior to the ban which went into effect on January 1 of this year.[2]

If you think we’re talking about teenagers, think again. The study in question was a survey of adult vapers in the United States; specifically, adult ex-smokers who had quit successfully using e-cigarettes and who are currently relying upon these products to keep them from returning to cigarette smoking.

National estimates suggest that there are at least 5 million adult vapers who rely upon e-cigarettes to keep themselves off highly addictive and deadly tobacco-burning cigarettes.[3] And most of these former smokers are reliant upon flavored e-liquids, because the whole point of vaping for adult smokers is to get away from the taste of, and dependence on tobacco.

It is true, of course, that a worrisome proportion of youths are vaping, and most of them — like their adult counterparts — enjoy flavored, as opposed to tobacco-tasting, e-liquids.

But even more worrisome is that in an effort to address the problem of youth vaping, the state legislature has thrown the state’s former smokers who rely upon e-cigarettes to keep them off real cigarettes under the bus by banning the sale of practically all e-cigarettes while allowing the real cigarettes to remain on store shelves.

Here’s the problem: While youth vaping, and especially the use of flavored products, is a serious problem, the reality is that youth are not the only ones who use these products. E-cigarettes are responsible for at least 5 million former smokers having quit smoking completely. If these products remain off the shelves in Rhode Island much longer, it will likely cause a large number of them to return to smoking because it is now much easier for them to just pick up a pack of Marlboros in Rhode Island than to continue purchasing the e-cigarettes that were keeping them from returning to smoking.

A study published in the New England Journal of Medicine found that e-cigarettes are twice as effective as the nicotine patch in helping smokers quit completely.[4] These products are truly a life-saver for literally millions of former smokers. And most of these former smokers prefer flavored products. Research has demonstrated that flavored e-cigarettes are much more effective than unflavored (i.e., tobacco-flavored) e-cigarettes in helping smokers to quit.[5]

The law that went into effect on January 1 eliminated the sale of more than 95% of e-cigarettes. However, it allowed the sale of 100% of real cigarettes to continue unabated. This means that it has now become much easier for both youth and adults in Rhode Island to get access to a Marlboro than to a cherry vape. What possible justification is there for eliminating the sale of fake cigarettes, but allowing the real ones to continue to be sold?

Not only will this likely result in many former smokers going back to smoking but it may also lead to many youth figuring out that it is much easier for them to smoke than to try to track down an e-cigarette. In fact, several recent studies have demonstrated that in states that banned flavored e-cigarettes, youth smoking rates have actually increased compared to states that still allow flavored e-cigarettes to be sold.[6]

The last thing in the world that we should be doing is to give tobacco cigarettes, which kill more than 400,000 Americans each year, a competitive advantage over fake (electronic) cigarettes, which contain no tobacco, involve no combustion, are much safer than combustible cigarettes, and whose use has not been implicated in a single death despite 15 years on the market.

My message to you today is that there is simply no public health justification for banning electronic cigarettes but allowing combustible tobacco cigarettes to remain. The law that went into effect on January 1 is inconsistent with the protection of the public’s health and has no public health justification. What possible justification can you give for removing e-cigarettes from stores, but allowing those very same stores to sell Marlboros and Camels, two of the most dangerous consumer products in history?

If you really want to protect the public’s health and are sincere in wanting to reduce tobacco-related disease and nicotine addiction, then there is an option that is readily available: continue to restrict the sale of all flavored nicotine-containing products at most stores but allow adults over the age of 21 to purchase flavored e-cigarettes at adult-only vape shops, which have a strong track record of preventing youth access. This would allow vaping products to compete with cigarettes on a level playing field, avoid the incentivization of former smokers to return to smoking, and protect youth from easy access to vaping products, all at the same time.

This is exactly what S543 would accomplish. I urge you to set an example for states across the nation by allowing the sale of flavored e-cigarettes to adults in 21-and over vape shops so that Rhode Island smokers will continue to have access to a life-saving product that is helping tens of thousands of Ocean Staters to remain off deadly tobacco cigarettes.

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[1] Leventhal AM, Dai H. Prevalence of flavored e-cigarette use among subpopulations of adults in the United States. Journal of the National Cancer Institute 2020;113(4):418-424. https://doi.org/10.1093/jnci/djaa118.

[2] Based on data from Truth Initiative, April 5, 2024. https://truthinitiative.org/research-resources/smoking-region/tobacco-use-rhode-island-2023.

[3] My calculations based on data from the National Health Interview Survey, 2023.

[4] Hajek P, et al. A randomized trial of e-cigarettes versus nicotine-replacement therapy. New England Journal of Medicine 2019; 380:629-637. https://www.nejm.org/doi/full/10.1056/NEJMoa1808779.

[5] Li L, Borland R, Cummings KM, et al. How does the use of flavored nicotine vaping products relate to progression toward quitting smoking? Findings from the 2016 and 2018 ITC 4CV surveys. Nicotine & Tobacco Research 2021;23(9):1490-1497. https://doi.org/10.1093/ntr/ntab033.

[6] Friedman AS, Pesko MF, Whitacre TR. Flavored e-cigarette sales restrictions and young adult tobacco use. JAMA Health Forum 2024;5(12):e244594. https://doi.org/10.1001/jamahealthforum.2024.4594.