The Silent Threat: Understanding “Popcorn Lung” and the Hidden Dangers of Vaping

In a world where vaping has been marketed as a safer alternative to traditional smoking, a disturbing reality is emerging: the potentially permanent and life-altering damage these devices may cause to our lungs. Recent headlines about a 17-year-old cheerleader diagnosed with “popcorn lung” after three years of secret vaping have thrust this serious condition back into the spotlight, raising urgent questions about the safety of e-cigarettes, particularly for young users. As the popularity of vaping continues to surge among teenagers and young adults, understanding the very real dangers of this seemingly innocent habit has never been more critical.

The Alarming Case That Shocked Parents and Health Experts

The case that recently captured headlines involves Brianne Cullen, a 17-year-old high school cheerleader whose life took a devastating turn in January 2025. During cheerleading practice, Cullen unexpectedly called her mother, repeatedly saying, “I can’t breathe.” Her mother, who described it as “the scariest thing,” rushed her to the hospital. People What doctors discovered was alarming – Cullen had developed bronchiolitis obliterans, commonly known as “popcorn lung.”

According to reports, Brianna had been secretly using disposable vapes daily for three years before her diagnosis. The Week Like many teens, she had concealed her habit from her parents, who were shocked to discover that their daughter’s mysterious breathing difficulties stemmed from vaping. The diagnosis was particularly devastating because, unlike many respiratory conditions, popcorn lung causes permanent, irreversible damage to the lungs.

The news of Brianne’s condition follows other documented cases, including a Canadian teenager who made headlines in late 2019. The 17-year-old boy had been vaping heavily for months, using various flavored products purchased online, including “green apple,” “dew mountain,” and “cotton candy.” His condition became so severe that doctors had to put him on life support. NBC News These cases represent the human face of a growing health crisis that experts have been warning about for years.

What Exactly Is “Popcorn Lung”?

Despite its innocuous-sounding name, popcorn lung is a serious and irreversible medical condition. Officially known as bronchiolitis obliterans, popcorn lung is a rare but serious disease that damages the tiny airways in the lungs, leading to persistent coughing, wheezing, fatigue, and breathlessness. Science Alert The condition earned its nickname through tragic circumstances.

Over a decade ago, workers in a microwave popcorn factory were sickened by breathing in diacetyl—a buttery-flavored chemical used in foods like popcorn, caramel, and dairy products. This flavoring was linked to deaths and hundreds of cases of bronchiolitis obliterans. Lung As a result, major popcorn manufacturers removed diacetyl from their products to protect workers.

The way popcorn lung develops is particularly insidious. The condition causes the airways to become inflamed and permanently scarred, leading to reduced airflow and difficulty breathing. Summahealth As the smallest

passages in the lungs (bronchioles) become scarred and narrowed, oxygen has increasingly limited ability to move through them, creating a progressive worsening of symptoms that can eventually lead to respiratory failure.

While the name might suggest a transient or minor issue, the reality is far more severe. Once the lungs are damaged, treatment is limited to managing symptoms. This can include bronchodilators, steroids, and in extreme cases, lung transplantation. Science Alert Unlike many respiratory conditions that can improve with time and treatment, the damage from popcorn lung is permanent and irreversible.

The Vaping Connection: How E-Cigarettes May Cause Popcorn Lung

The link between vaping and popcorn lung centers around the chemical composition of e-liquids, particularly the flavoring agents used to make them appealing. Even though diacetyl causes popcorn lung, this chemical is found in many e-cigarette flavors. It is added to “e-juice” liquid by some e-cigarette companies to complement flavorings such as vanilla, maple, coconut, and more. Lung In effect, vapers may be directly inhaling the very chemical that caused factory workers to develop this serious lung disease.

The scope of the problem is substantial. Researchers at Harvard found that 39 of 51 e-cigarette brands contained diacetyl. The study also found two similarly harmful chemicals—2,3 pentanedione and acetoin—present in 23 and 46 of the 51 flavors it tested. Roughly 92 percent of the e-cigarettes had one of the three chemicals present. Lung These findings raise serious questions about the safety of flavored vaping products.

The risk extends beyond just diacetyl. While diacetyl is the most infamous cause, popcorn lung can also be triggered by inhaling other toxic chemicals, including volatile carbonyls like formaldehyde and acetaldehyde – both of which have also been detected in e-cigarette vapors. Science Alert These chemicals can cause similar inflammatory responses in the lungs, leading to scarring and permanent damage.

What makes this particularly concerning is the vast array of chemicals used in e-cigarettes, many of which haven’t been properly tested for safety when inhaled. Experts estimate there are over 180 different flavoring agents used in e-cigarette products today. When heated, many of these chemicals break down into new compounds – some of which have never been tested for inhalation safety. Science Alert This creates a largely unknown risk profile for vapers, especially young ones whose lungs are still developing.

A Critical Difference: Eating vs. Inhaling

Understanding the danger of vaping flavoring agents requires recognizing a crucial distinction between consuming a chemical in food versus inhaling it directly into the lungs. When chemicals are eaten, they go through the digestive system and are processed by the liver before entering the bloodstream. But when chemicals are inhaled, they bypass this filtration system entirely. They go straight into the lungs – and from there, directly into the bloodstream, reaching vital organs like the heart and brain within seconds. Science Alert

This direct pathway explains why chemicals that are considered safe in food can become dangerous when vaporized and inhaled. Eating butter-flavored popcorn is totally fine, but breathing in the buttery chemical can be devastating. Science Alert The lungs simply aren’t designed to process these chemical compounds, especially when they’re heated and transformed into potentially more toxic substances.

The widespread use of flavoring agents in vaping products creates a particularly insidious risk because many of these flavors specifically target younger users. Vaping is especially popular among teenagers and young adults, possibly due to the thousands of flavored vape products available – from bubblegum to cotton candy to mango ice. Science Alert These appealing flavors mask the serious chemical exposure taking place with each inhalation.

Regulation and Safety: A Patchwork Approach

The regulatory landscape around vaping and its chemical components varies significantly across different countries and regions. Diacetyl is officially banned in e-cigarettes in the EU and UK, but not in the US and other jurisdictions. The Conversation This creates an uneven level of protection for consumers, with some regions implementing stricter safeguards than others.

Even in places with regulations, enforcement challenges remain. Illegal vapes that may not comply with regulations are common. The Conversation The ease of purchasing vaping products online or through unofficial channels means that even in regions with bans on harmful chemicals like diacetyl, users may still be exposed to these substances.

The UK has implemented some of the strictest measures globally. Under the Tobacco and Related Products Regulations 2016, e-cigarette products are subject to minimum standards of quality and safety, as well as packaging and labeling requirements to provide consumers with information. Blog These regulations include the ban on diacetyl and certain other harmful chemicals in e-liquids.

In the US, regulation has been more complex and fragmented. While the FDA has authority over tobacco products, including e-cigarettes, the agency’s oversight has been challenged by the rapidly evolving market and the vast array of products. This has created situations where potentially harmful products remain available to consumers, especially young people.

The Scientific Debate: Conflicting Perspectives

It’s important to note that not all health authorities agree on the direct link between vaping and popcorn lung. According to Cancer Research UK, there have been no confirmed cases of popcorn lung linked to e-cigarettes. Cancer Research UK This highlights the ongoing scientific debate about the exact risks of vaping and the specific health conditions it may cause.

Some health organizations maintain that while vaping isn’t risk-free, it represents a less harmful alternative to traditional smoking. The NHS in the UK states that cigarettes release thousands of different chemicals when they burn, many of which are poisonous and up to 70 cause cancer. Most of these harmful chemicals in cigarette smoke, including tar and carbon monoxide, are not contained in vape aerosol. Nhs

However, this position doesn’t mean vaping is safe, particularly for young people who weren’t smokers to begin with. Johns Hopkins lung cancer surgeon Stephen Broderick notes: “In the last 24 to 36 months, I’ve seen an explosive uptick of patients who vape. With tobacco, we have six decades of rigorous studies to show which of the 7,000 chemicals inhaled during smoking impact the lungs. But with vaping, we simply don’t know the short- or long-term effects yet and which e-cigarette components are to blame.” Hopkinsmedicine

This uncertainty is complicated by the fact that vaping is a relatively new phenomenon, and the long-term effects may take decades to fully emerge. Research about exactly how vaping affects the lungs is in the initial stages. Hopkinsmedicine The scientific community continues to study these impacts, but in the meantime, users—especially young people—are essentially participating in a large-scale, uncontrolled experiment on the human respiratory system.

Beyond Popcorn Lung: Other Vaping-Related Health Concerns

While popcorn lung has received significant attention, it represents just one of several serious respiratory conditions potentially linked to vaping. According to Johns Hopkins Medicine, several lung diseases are associated with vaping, including lipoid pneumonia and primary spontaneous pneumothorax (collapsed lung). Hopkinsmedicine

Lipoid pneumonia develops when fatty substances (oils) from vaping liquids enter the lungs and trigger inflammation. Unlike bacterial pneumonia, this condition results directly from the inhalation of oily components in e-liquids. According to Dr. Broderick, “There isn’t a good treatment for lipoid pneumonia, other than supportive care, while the lungs heal on their own. The single-most important thing you can do is identify what is causing it — in this case vaping — and eliminate it.” Hopkinsmedicine

Another serious condition is collapsed lung, which occurs when air blisters on the top of the lungs rupture. Health professionals at Johns Hopkins report seeing “a rash of collapsed lungs in younger people” related to vaping. Hopkinsmedicine These patients often require emergency intervention and may face recurrent lung collapses if they continue to vape.

The EVALI crisis (E-cigarette or Vaping product use-Associated Lung Injury) of 2019 highlighted yet another danger. The outbreak saw 68 deaths and over 2,800 hospitalizations in the US. That outbreak was eventually linked to vitamin E acetate – a thickening agent in some cannabis vape products. When heated, it produces a highly toxic gas called ketene. Science Alert This crisis demonstrated that even ingredients considered safe in other contexts can become deadly when vaporized and inhaled.

The Youth Epidemic: Why Teens Are Particularly Vulnerable

The risks of vaping-related lung damage are especially concerning for young people, who have become the primary users of these products in many regions. A multi-national study found that adolescents who vape report significantly more respiratory symptoms, even when adjusting for smoking status. Certain flavor types, nicotine salts, and frequency of use were all linked to these symptoms. Science Alert

Several factors make young people particularly vulnerable to both the appeal of vaping and its potential health impacts. First, adolescent lungs are still developing, making them potentially more susceptible to damage from inhaled chemicals. Second, the marketing of vaping products often specifically targets youth through appealing flavors and sleek, discreet designs that are easy to conceal from parents and teachers.

The addictive nature of nicotine, which is present in most vaping products, creates another significant concern for young users. According to Harvard Health, nicotine is highly addictive and can affect the developing brain, potentially harming teens and young adults. Even some “nicotine-free” e-cigarettes have been found to contain nicotine. Harvard Health This addiction can establish patterns of use that may persist into adulthood, increasing the lifetime exposure to potential lung-damaging chemicals.

Perhaps most troublingly, vaping may serve as a gateway to traditional cigarette use for young people. Teens who vape are more likely to begin smoking cigarettes, and many young people who use e-cigarettes also smoke cigarettes. Harvard Health This contradicts the narrative that vaping serves primarily as a harm reduction tool for existing smokers.

Prevention: The Only Real Defense

Given the irreversible nature of popcorn lung and other serious vaping-related respiratory conditions, prevention emerges as the only viable strategy to protect lung health. There’s no cure for popcorn lung. Once the lungs are damaged, treatment is limited to managing symptoms. For this reason, prevention – not treatment – is the best and only defense. Science Alert

For parents, this means having frank conversations with children about the risks of vaping and being vigilant about potential signs of use. Brianne Cullen’s mother had no idea her daughter was vaping: “I would walk into her room all the time and I never saw her vaping. It took a deadly diagnosis for her to stop.” People The discreet nature of modern vaping devices makes detection particularly challenging, requiring increased awareness and education.

For policymakers, effective prevention requires stronger regulation and enforcement. Just as workplace safety rules were overhauled to protect popcorn factory workers, similar regulatory urgency is needed for the vaping industry – especially when it comes to protecting the next generation. Science Alert This may include stricter controls on flavors that appeal to youth, better enforcement of age restrictions, and more comprehensive testing of the chemical components in vaping products.

Healthcare providers also play a crucial role in prevention by screening for vaping use during routine visits and providing clear information about the risks. As more research is conducted on the long-term effects of vaping, it’s important for individuals to stay informed and make choices that prioritize health. Summahealth

Navigating the Future: Harm Reduction vs. Unknown Risks

The conversation around vaping often centers on its potential role in harm reduction for existing smokers versus the unknown risks it poses, particularly to non-smokers who take up vaping. Some evidence suggests vaping helps some people stop smoking, though other research contradicts this. How it compares to a nicotine patch or other methods of smoking cessation is not clear. Harvard Health This uncertainty creates a complex calculus for public health messaging.

For current smokers looking to quit, the evidence suggests that while vaping may still carry health risks, these risks are likely lower than continued cigarette smoking. People who switch completely from smoking to vaping have reduced exposure to toxins associated with risks of cancer, lung disease, heart disease, and stroke. Nhs In this specific context, vaping may represent a step toward reducing harm.

However, for non-smokers—especially young people—the equation is entirely different. Taking on any risk from vaping without the offset of reducing existing smoking harms represents a clear net negative for health. “The single-most important thing you can do is identify what is causing it — in this case vaping — and eliminate it.” Hopkinsmedicine This straightforward advice from medical professionals underscores the fundamental approach to vaping-related health concerns.

The Personal Cost: Living with Permanent Lung Damage

Beyond the statistics and medical terminology, the reality of popcorn lung and other vaping-related conditions represents a profound personal tragedy for those affected. Cullen now relies on an inhaler to help with her breathing, and as her mother told reporters, “We don’t know the status of her lungs now. We still don’t know if there will be long-term effects.” People This uncertainty about future health outcomes adds another layer of stress to an already difficult situation.

For teenagers like Brianne, a diagnosis of an irreversible lung condition means potentially living with breathing difficulties and limitations for decades to come. Activities that most young people take for granted—sports, physical exertion, even climbing stairs—may become challenging or impossible. Bronchiolitis obliterans is an irreversible and chronic condition. However, there are treatments available to manage the symptoms and slow progression of the disease. Uhhospitals These treatments represent not a cure, but rather a lifelong management of a preventable condition.

The emotional impact on both the affected individuals and their families can be substantial. Brianne’s experience has transformed her mother into an advocate for removing these products from the market altogether to protect other children from similar health crises. Karmactive This advocacy represents one way families cope with the devastating knowledge that their loved one’s condition could have been prevented.

A Call for Clarity: What We Know and Don’t Know

As research continues to evolve, it’s important to acknowledge both what we know with certainty about vaping and where gaps in our understanding remain. Some research suggests there is 750 times more diacetyl in a pack of cigarettes than in a day’s worth of vaping nicotine fluid, and to date we have no confirmation that smokers are getting popcorn lung. CMAJ This highlights the complexity of the risk assessment and the need for continued scientific investigation.

At the same time, certain facts have been clearly established. Other common substances found in e-liquid or produced when it’s heated up may also pose a risk to the lungs. These include diacetyl, which is known to damage small passageways in the lungs; formaldehyde, which can cause lung disease and contribute to heart disease; and acrolein, which can also damage lungs. Hopkinsmedicine The presence of these chemicals in vaping products is not disputed, even as their exact health impacts continue to be studied.

The relative newness of vaping technology means that many long-term effects remain unknown. Over time, as e-cigarette use continues, experts will gain a better understanding of how vaping affects the lungs. Hopkinsmedicine Unfortunately, this means that current users are essentially participants in an ongoing health experiment, with potentially serious consequences.

Regulatory Responses Around the World

Different countries have taken varied approaches to regulating vaping products and addressing their potential health risks. Governments are increasingly taking action to address the youth vaping epidemic: The UK announced in October 2023 that disposable vapes will be banned starting June 2025; some countries have regulated or banned certain chemicals in vaping products; many jurisdictions have increased age verification requirements and marketing restrictions; and some regions have implemented flavor bans targeting products that appeal to youth. Karmactive

The nature and extent of these regulations vary significantly by region. In the United Kingdom, for example, diacetyl was banned in e-cigarettes and e-liquids under the EU Tobacco Products Directive (TPD) in 2016. So, legal e-liquids sold in the UK aren’t allowed to contain diacetyl. Cancer Research UK This creates a clearer regulatory environment, though enforcement challenges remain, particularly with products sold online or through unregulated channels.

In the United States, the regulatory approach has been more complex and evolving. The FDA has authority over vaping products but has faced challenges in effectively regulating the rapidly changing market. The American Lung Association believes it’s imperative that the FDA act quickly to require that diacetyl and other harmful chemicals be removed from e-cigarettes. Lung This reflects ongoing advocacy for stronger regulatory protections in the US market.

The Path Forward: Education, Research, and Prevention

Addressing the potential dangers of vaping, including the risk of popcorn lung, requires a multi-faceted approach combining education, continued research, and preventive measures. While popcorn lung is a rare disease, its association with vaping has raised concerns in the healthcare community. Summahealth These concerns have driven calls for greater public awareness of the risks associated with e-cigarettes.

Education efforts need to target not only young people but also parents, educators, and healthcare providers. “I would urge parents to spread awareness. This is meant to be a cautionary tale to not let your kids vape no matter what,” urged Brianne Cullen’s mother. People Personal stories like Brianne’s can be particularly effective in communicating the real-world impacts of what might otherwise seem like abstract health risks.

Continued scientific research is essential to better understand the specific mechanisms by which vaping may damage the lungs and to identify which chemical components pose the greatest risks. Studies of the health effects of e-cigarettes are ongoing. Harvard Health This research will be crucial in developing more targeted regulations and in providing clearer guidance to both healthcare providers and the public.

Preventive measures should focus particularly on protecting young people, who represent the most vulnerable population for both initiating vaping and potentially experiencing long-term health consequences. Teenagers and young adults are particularly vulnerable to the risks of vaping, as their lungs are still developing. Summahealth Age restrictions, marketing limitations, flavor bans, and school-based prevention programs all represent potential tools in preventing youth vaping initiation.

Conclusion: The Imperative of Protection

The case of Brianne Cullen, the 17-year-old cheerleader diagnosed with popcorn lung after three years of secret vaping, stands as a stark warning about the potential dangers of e-cigarettes. While scientific debate continues about the precise relationship between vaping and this rare lung condition, the irreversible nature of the damage underscores the importance of a precautionary approach, particularly for young people.

Popcorn and vaping might seem worlds apart, but they’re connected by a common thread: exposure to inhaled chemicals that were never meant for the lungs. The danger lies not in what these chemicals are when eaten, but in what they become when heated and inhaled. Science Alert This fundamental insight helps explain why chemicals considered safe in food products can become dangerous when vaporized and directly inhaled into the lungs.

As we continue to learn more about the health impacts of vaping, the stories of those affected by serious respiratory conditions serve as powerful reminders of what’s at stake. For Brianne, the consequences of her vaping habit will likely follow her for life. Her story serves as a powerful warning about the potential dangers lurking in these increasingly popular devices – dangers that many teens and parents may not fully understand until it’s too late. Karmactive

The urgent challenge facing parents, educators, healthcare providers, researchers, and policymakers is to ensure that more young people don’t face similar fates. By combining strong regulatory protections, effective education, continued research, and compassionate care for those already affected, we can work toward a future where the hidden dangers of vaping no longer claim the health and futures of our youth.

In the end, prevention remains not just the best approach but the only truly effective one for conditions like popcorn lung. Taking steps to reduce your risk now can lead to better lung health in the future. Summahealth This simple truth underlies all efforts to combat the potential dangers of vaping and to protect the respiratory health of current and future generations.