Vaping can cause pneumothorax, commonly called a collapsed lung. Published case reports and a 2025 systematic review document the link, with most cases occurring in young, underweight men between the ages of 15 and 25. While the total number of documented cases is still relatively small, the pattern is consistent enough that researchers now consider vaping a recognized risk factor for spontaneous lung collapse.
How Vaping Damages Lung Tissue
A pneumothorax happens when air leaks out of the lung and into the space between the lung and the chest wall. That trapped air puts pressure on the lung, causing it to partially or fully collapse. In most spontaneous cases, the leak starts at a weak spot on the lung surface, typically a small air-filled blister called a bleb or bulla.
Vaping appears to create those weak spots through a combination of chemical injury and inflammation. The nicotine and flavoring compounds in e-cigarette aerosol are toxic to the cells lining the airways and air sacs. High-nicotine devices have been shown to cause significant oxidative stress, inflammation, and breakdown of the barrier between the air sacs and surrounding blood vessels. Over time, this damage can produce blebs on the lung surface or make the outer lining of the lung more porous. Either change makes a spontaneous air leak more likely.
This is the same basic mechanism behind smoking-related pneumothorax. Traditional cigarettes have long been the single biggest risk factor for spontaneous lung collapse. Vaping products deliver many of the same irritants, and some high-concentration nicotine devices may deliver them in larger doses per puff than a conventional cigarette.
Who Is Most at Risk
The typical patient in published vaping-related pneumothorax cases is strikingly consistent. A systematic review covering 16 documented cases found that 81% were male, and 75% were between 15 and 25 years old. Most were classified as underweight or at the lower end of normal weight. Being tall and thin is already a known risk factor for spontaneous pneumothorax regardless of smoking status, because taller people tend to have more pressure variation between the top and bottom of their lungs. Vaping appears to stack additional risk on top of that baseline vulnerability.
Many of the documented patients also used cannabis or conventional cigarettes alongside their e-cigarettes, making it difficult to isolate vaping as the sole cause in every case. But the combination of substances likely compounds the damage. Whether you vape nicotine, THC, or both, the inflammatory burden on your lungs adds up.
Symptoms to Watch For
The hallmark symptoms of a collapsed lung are sudden, sharp chest pain and shortness of breath. The chest pain often comes on without warning and worsens when you take a deep breath. In some cases, the pain radiates to the shoulder on the same side as the collapse. That shoulder pain pattern is worth paying attention to: in the systematic review, patients whose chest pain radiated to the shoulder on the affected side were significantly more likely to have a recurrence later.
Other signs include difficulty breathing that doesn’t improve with rest, a feeling of tightness in the chest, and rapid heart rate. A small pneumothorax may cause only mild discomfort. A large one can be a medical emergency. If you vape and experience sudden sharp chest pain or unexplained breathing difficulty, those symptoms warrant urgent evaluation rather than a wait-and-see approach.
What Happens During Treatment
A small pneumothorax sometimes resolves on its own with observation and rest as the body reabsorbs the leaked air. Larger collapses typically require a tube inserted through the chest wall to drain the trapped air and let the lung re-expand. In some cases, surgery is needed to seal the leak and remove the damaged blebs.
The choice between these approaches matters for what comes next. Among the 16 patients in the systematic review, six experienced a recurrence after their first episode. Every one of those recurrences happened in patients who had initially been treated without surgery. Patients who underwent surgical repair after their first collapse did not have documented recurrences. This pattern has led researchers to suggest that earlier surgical intervention, particularly for patients with risk factors for recurrence, may reduce long-term complications.
One illustrative report described two teenage boys, ages 15 and 16, who both developed spontaneous pneumothorax after vaping. Both were initially treated with chest tubes. Both had recurrences that ultimately required surgery. After the surgical repairs, neither experienced another collapse.
Recurrence and Continued Vaping
Recurrence is the central concern with vaping-related pneumothorax. Once your lung has collapsed once, the risk of it happening again is already elevated. Continuing to vape after a pneumothorax maintains the cycle of inflammation and tissue damage that caused the problem in the first place. Stopping vaping won’t reverse existing blebs, but it removes the ongoing chemical assault that makes new ones form and existing weak spots rupture.
Researchers emphasize that a thorough vaping history is important for anyone presenting with a pneumothorax, because identifying vaping as a contributing factor opens the door to cessation support and may change the treatment strategy. If your doctor doesn’t ask about vaping, bring it up yourself.
What CT Scans Reveal
When doctors image the lungs of people with vaping-related lung damage, they commonly find a pattern called ground-glass opacity, which looks like a hazy whitening on the scan. In a study of 160 cases of vaping-associated lung injury, this haziness appeared in characteristic locations: it tended to spare the edges of the lungs directly under the chest wall (78% of cases) and the small airway regions, while affecting broader areas of both lungs. These imaging patterns help doctors distinguish vaping-related damage from infections or other lung conditions, but they also reveal the extent of inflammation happening beneath the surface, even in areas of the lung that haven’t collapsed.
In patients with pneumothorax specifically, CT scans often reveal the blebs or bullae responsible for the air leak, along with surrounding inflammation. These findings can guide surgical planning if repair is needed.