Opinion: Vaping and Vitamin E: What Went Wrong?

It turns out that the US Preventive Services Task Force has a recommendation against this supplementation.

Many people struggle to quit smoking cigarettes to prevent and slow lung diseases, such as chronic obstructive pulmonary disorder.

Nicotine is such an addictive substance that in a desperate attempt to get healthy many people turned to e-cigarettes, which delivered the nicotine in a vapor instead of smoke. But instead of getting healthier, these former smokers got worse. In addition, healthy, young people started experimenting with recreational vaping, and despite their health and youth, they, too, developed serious lung problems.

Why did this happen? What went wrong? After much investigation, it was discovered that vitamin E was added to e-cigarette vaping formulations to help preserve lung function. But it backfired. Instead, vitamin E caused lung damage.

Theoretically, it was an excellent idea. Any time there is excessive oxidative stress on the body, antioxidants can potentially improve the situation.1 Antioxidants are used in a nebulized inhaled form to treat cystic fibrosis and other lung diseases. The antioxidant is called N-acetylcysteine. It mitigates the oxidative damage and thins the mucus to preserve lung function. 2

It appears that the manufactures of e-cigarettes chose the wrong antioxidant. They chose vitamin E, and at first, it sounds like a good choice. Vitamin E is used topically to preserve youthful skin, and it is used in grocery stores to prevent meat from prematurely becoming discolored after it has been cut and exposed to air.

But the manufactures missed an important red flag. The US Preventive Services Task Force has a recommendation against vitamin E supplementation.3 These government-appointed medical experts did a thorough literature review and statistical analysis, and found that those who want to avoid cancer and cardiovascular disease and live longer should not use synthetic vitamin E pills.

How could that be? Our bodies need vitamin E to function properly and keep us alive. Why is it classified as a vitamin if it could potentially harm us?

To understand the answer, we must understand that vitamin E is a collective term used to describe 8 natural compounds. These compounds are called tocopherol and tocotrienol, and they are subclassified as alpha, beta, gamma, and delta.4

Synthetic vitamin E pills are usually only 1 of these 8 compounds: alpha-tocopherol. It is very unnatural for a single antioxidant to be found in nature or in our body alone in high amounts. It turns out that antioxidants need each other.4 They need to juggle electrons between themselves to perform their antioxidant activities. After they absorb rouge, flay-way electrons, they toss their unwanted electrons to a different antioxidant that need electrons to perform their necessary functions. This juggling allows antioxidants to return to their original state and repeat the process of neutralizing excessive free radicles. This is called synergy, and it is demonstrated in many studies.4,5

Vitamin C and E have especially good synergy together. They have been tested both orally and topically. Researchers saw the ability of these compounds to neutralize the oxidative damage caused by the sun in people with fair skin. They could see and measure the redness cause when the vitamins were used alone and together.5

Going back to synthetic vitamin E being inhaled and applied topically to lung tissue, this is what went wrong: The single tocotrienol did not have another antioxidant in high amounts with which to juggle electrons back and forth. It is my opinion that vitamin E in the vaping formulations got what it needed in terms of electrons from the surrounding lung tissue. That is how the damage occurred. It was similar to inhaling battery acid, and that is why healthy young people started showing up in emergency departments coughing up blood and ending up in respiratory failure as a result of vaping.6


  • Maurya PK, Kumar P, Chandra P. Biomarkers of oxidative stress in erythrocytes as a function of human age. World J Methodol. 2015;5(4):216-222. doi:10.5662/wjm.v5.i4.216
  • Sadowska AM, Verbraecken J, Darquennes K, De Backer WA. Role of N-acetylcysteine in the management of COPD. Int J Chron Obstruct Pulmon Dis. 2006;1(4):425-434. doi:10.2147/copd.2006.1.4.425
  • Final recommendation statement: vitamin supplementation to prevent cancer and CVD: preventive medication. US Preventive Services Task Force website. uspreventiveservicestaskforce.org/uspstf/recommendation/vitamin-supplementation-to-prevent-cancer-and-cvd-counseling. Published September 27, 2014. Accessed January 25, 2020.