A presentation at the American Thoracic Society 2025 International Conference outlined a program that identified patients at risk for e-cigarette and vaping product use-associated lung injury (EVALI). The quality-improvement project implemented routine screening for vaping product use and symptoms of pulmonary complications of vaping.
“E-cigarette and vaping product use is prevalent among adolescents and young adults, leading to EVALI and other pulmonary complications,” wrote the authors, led by Maria Moncaliano, MD, of Boston Children’s Hospital in Massachusetts. “Our global aim was to reduce the incidence and impact of EVALI through comprehensive screening, education, and effective management strategies.”
The authors launched a division-wide quality-improvement project in June 2021 to verbally screen patients during intake at their pediatric pulmonary ambulatory clinic. They developed a three-question screening tool that asked:
- In the past year, have you or anyone in your house ever vaped an e-cigarette, JUUL, dab pen, puff bar, atomizer, or other vaping device?
- Have you ever vaped or used an e-cigarette, JUUL, dab pen, puff bar, diffuser, atomizer, or other vaping device?
- In the past three months, have you had a new or worsening cough, chest pain, shortness of breath, coughing up blood, abdominal pain, nausea, vomiting, diarrhea, night sweats, or weight loss?
Implementation rates varied widely, with an average of 58%. During the project’s first year, therate was 72%, which rose over time to 83%, then 93% by August 2023. However, the rate dropped 42% during a period of low staffing and 22% during a change in the electronic health record system. Overall, the project had 4% positive screenings in 2022, 5% in 2023, and 5% in 2024. Most were first-time positive screens [Figure 1C].
The authors plan to continue by improving screening rates and evaluating inequities among unscreened patients.
Reference
Moncaliano MC, Tran V, Gordon R, et al. Vaping Screening: A quality improvement project to screen for pediatric vape use and symptoms of pulmonary complications of vaping in an ambulatory setting. Abstract #A2273. Presented at the American Thoracic Society International Conference; May 18-21, 2025; San Francisco, California.
