It starts with a sharp, stabbing pain. Maybe you think you pulled a muscle at the gym or slept on your side wrong. Then you take a breath, and it feels like your chest is being squeezed by a cold metal vice. You can't quite get enough air. This isn't just "vaper’s cough" or a bit of congestion. For a growing number of young people, this is the first sign of a collapsed lung from vaping, a medical emergency that sounds like something out of a freak accident but is becoming surprisingly common in respiratory wards across the country.
The technical term is spontaneous pneumothorax.
Basically, air leaks out of your lung and gets trapped in the space between the lung and the chest wall. That trapped air pushes on the outside of the lung until it flattens. Imagine a balloon inside a cardboard box. If the balloon gets a hole, it shrivels up, and no matter how much you try to blow into the box, that balloon isn't inflating.
Why is this happening to vapers?
Doctors have known about "tall, thin young men" being prone to collapsed lungs for decades. It’s a weird quirk of anatomy. But the surge we’re seeing now involves people who don't fit that old-school profile. The common thread? High-output nicotine delivery systems and those massive clouds of vapor.
When you vape, you aren't just inhaling flavored air. You are pulling a complex aerosol of propylene glycol, vegetable glycerin, and heavy metals into the deepest, most fragile parts of your lungs. This irritates the tissue. Over time, this chronic inflammation can lead to the formation of "blebs." These are tiny, blister-like air sacs on the surface of the lung.
One day, you take a deep hit, or maybe you just sneeze, and one of those blebs pops.
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That’s all it takes. Once that "blister" ruptures, the seal is broken. Atmospheric pressure takes over, and your lung gives up. It’s a mechanical failure caused by chemical irritation. Researchers at Johns Hopkins have been sounding the alarm on this for a while, noting that the sheer force of inhalation required for some devices might be adding mechanical stress to lungs already weakened by chemical exposure.
The "EVALI" hangover and what we know now
Remember 2019? That was the year of EVALI (E-cigarette or Vaping Use-Associated Lung Injury). Thousands of people ended up hospitalized, and many died. Most of those cases were eventually traced back to vitamin E acetate, a thickening agent often used in illicit THC carts.
But here’s the thing: people are still getting a collapsed lung from vaping even without vitamin E acetate.
It’s not just the "black market" stuff anymore. We are seeing these injuries in kids using standard, store-bought nicotine disposables. The high concentration of nicotine salts allows users to take much deeper, more frequent hits without the "throat hit" that usually makes you stop. You’re basically marinating your lung tissue in inflammatory chemicals all day long.
Honestly, the lungs weren't built for this.
They are delicate. The alveoli—the tiny sacs where oxygen enters your blood—are only one cell layer thick. Think about how thin that is. When you blast them with heated chemicals 200 times a day, things break. Sometimes, they break catastrophically.
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The symptoms you shouldn't ignore
Most people try to "tough it out" for the first few hours. Don't do that. If you vape and you feel any of the following, you need to get to an urgent care or ER immediately:
- Sudden, sharp chest pain that gets worse when you try to take a deep breath.
- A feeling of tightness that doesn't go away with stretching.
- Shortness of breath even when you're just sitting on the couch.
- A rapid heart rate (your heart is panicking because it’s not getting enough oxygen).
- Skin turning a slightly bluish tint, especially around the lips or fingernails.
There’s a specific kind of "crunchy" feeling some people report. It’s called subcutaneous emphysema. It feels like Rice Krispies popping under your skin around your neck or chest. If you feel that, your lung has leaked air into your soft tissues. It's a massive red flag.
What happens in the hospital?
If you show up with a suspected collapsed lung from vaping, the first thing they’ll do is an X-ray or a CT scan. If the collapse is small (less than 20%), they might just give you oxygen and watch you. The body can sometimes reabsorb that trapped air on its own.
But if it’s a big collapse? They’re going to have to go in.
They usually insert a chest tube. They make an incision between your ribs, slide a tube into the pleural space, and hook it up to a suction canister. It’s not fun. It’s painful, and you’ll be hooked up to that machine for days until the hole in your lung heals. In some cases, if the lung keeps collapsing, surgeons have to perform a pleurodesis. This is where they essentially "glue" your lung to your chest wall using a chemical irritant like talc or by mechanically scarring the tissue so it sticks.
It’s a permanent fix for a problem that shouldn't have happened in the first place.
Is it reversible?
The good news is that the lung itself usually heals. But the damage that led to the collapse—the inflammation and the blebs—doesn't just vanish. If you keep vaping after a collapse, your chances of it happening again are incredibly high. We’re talking a 50% recurrence rate in some studies.
You’ve basically found the structural weak point in your body.
Actionable steps for vapers
If you’re worried about your lung health, or if you’ve already felt that weird twinge in your chest, here is what you actually need to do.
- Switch to a lower-wattage device immediately. The higher the heat, the more toxic the aerosol. If you're using a sub-ohm tank or a high-voltage mod, you're putting significantly more stress on your lung tissue than a low-power pod system.
- Stop the "deep lung" hits. Avoid the "direct-to-lung" (DTL) style of vaping. This forces the vapor deeper into the lower lobes where the most fragile tissue lives.
- Hydrate like your life depends on it. Propylene glycol is a humectant; it sucks moisture out of your mucous membranes. Dry lungs are more prone to irritation and tearing.
- Get a baseline checkup. Tell your doctor you vape. Seriously. They aren't there to narc on you. They need to listen to your lungs with a stethoscope to check for "decreased breath sounds," which is an early warning sign of air trapping.
- Phase out the disposables. Many of the cheap, disposable vapes found in gas stations have zero quality control. We’ve seen cases where the heating coils are leaching heavy metals like nickel and chromium directly into the vapor.
The reality is that collapsed lung from vaping isn't a myth or "anti-vaping propaganda." It's a mechanical reality of putting pressurized, heated chemicals into a biological system that evolved to breathe clean air. If your chest feels tight today, don't wait until tomorrow to see someone. A collapsed lung is treatable, but a tension pneumothorax—where the trapped air starts pushing on your heart—can be fatal in minutes. Listen to your body before it forced you to.
Next Steps for Recovery and Prevention
- Monitor your "Peak Flow": Buy a cheap peak flow meter from a pharmacy. It measures how fast you can push air out of your lungs. If your numbers start dropping over a week, your lungs are struggling.
- Transition to Nicotine Replacement Therapy (NRT): If you're hooked on the nicotine, try the patches or gum. They aren't "cool," but they don't involve putting holes in your pleura.
- Diaphragmatic Breathing: Once cleared by a doctor, practice deep belly breathing to help re-expand the lower lobes of your lungs and improve oxygen saturation.
The best time to stop was yesterday. The second best time is right now, before the "pop" happens.