There is a conversation happening in schools, on social media, in the homes of families across the Cayman Islands — and in clinics and emergency rooms around the world. It goes something like this: “It’s just vapor. It’s not like smoking. It can’t be that bad.” This blog exists to correct that assumption — clearly, compassionately, and with the science to back it up.
E-cigarettes and vaping products have been marketed aggressively, particularly to young people, as a modern, sleek, and safer alternative to cigarettes. The reality is far more complicated — and for some users, catastrophically so. A severe, potentially fatal lung condition called EVALI (E-cigarette or Vaping Product Use-Associated Lung Injury) has now been documented in thousands of patients, predominantly adolescents and young adults. It has killed people. And because it mimics other illnesses, it is frequently missed until it becomes critical.
“EVALI has emerged as a significant public health concern, particularly among adolescents and young adults.”
— Journal of Independent Medicine, 2026
What Is EVALI?
EVALI stands for E-cigarette or Vaping Product Use-Associated Lung Injury. It is a severe respiratory illness caused by inhaling chemicals found in vaping products. It is not an infection — you cannot catch it from someone else. It is a direct toxic injury to the lungs. EVALI was first identified in the United States in mid-2019, when reports of a mysterious respiratory illness began surfacing among young, otherwise healthy people. By the end of February 2020, the US CDC had recorded nearly 2,800 hospitalized cases and 68 deaths — all linked to vaping — across all 50 states and three US territories. It can also be called Vaping-Associated Pulmonary Injury (VAPI) or Vaping-Associated Lung Injury (VALI).
Who Is Most at Risk?
The data is clear and should alarm every parent, educator, and youth worker in the Caribbean and globally: EVALI disproportionately affects young people. The highest prevalence in early outbreak data was among young non-Hispanic white males aged 11 to 13 years — but the condition has been documented across age groups, genders, and demographics. In the Caribbean context, where vaping products are increasingly available and social media normalization of vaping is accelerating, this is not a distant American problem. It is a present and growing local one.
Risk escalates with higher doses and more frequent use. Many young people affected in the initial outbreak obtained their products from unofficial or unregulated sources — a pattern highly relevant in island communities where product sourcing may be difficult to monitor. Only about half of the countries in the world monitor e-cigarette use at all. The true burden of EVALI globally — including in the Caribbean — is almost certainly underestimated.
A Note for the Caribbean: This Is Not Someone Else’s Problem
The conditions that created the EVALI crisis are global. Vaping products are marketed globally and are increasingly available in the Caribbean. Social media normalization of vaping reaches young people in the Cayman Islands just as it does in New York or London. Unregulated and black-market vaping cartridges (the highest-risk products) circulate in island communities. The National Drug Council of the Cayman Islands plays a critical role in this landscape — through community education, policy advocacy, school-based programs, and supporting families navigating substance use. EVALI is not just a respiratory condition. It is a substance use consequence. And like all substance use consequences, it is preventable.
What Can Be Done: A Multi-Layered Response
For individuals and families: Have direct, honest conversations about vaping — not scare tactics, but facts. Know the symptoms of EVALI and seek care promptly if they appear. Understand that “nicotine-free” or “just flavors” vapes still carry toxic chemical risks. Connect with the National Drug Council for resources and support.
For clinicians and health educators: Include vaping history as a routine part of any respiratory assessment. Maintain a high index of suspicion for EVALI in young patients with respiratory symptoms and a negative infectious workup. Familiarize yourself with CDC diagnostic criteria and management guidance. Advocate for local EVALI surveillance and reporting systems.
For policymakers: Strengthen regulation of vaping product importation, sale, and marketing in the Cayman Islands. Invest in comprehensive e-cigarette surveillance to establish Caribbean-specific prevalence data. Support school-based vaping prevention curricula that lead with evidence, not abstinence-only messaging.
The Bottom Line
Vaping is not safe. For a meaningful number of users — particularly the young, the frequent, and those using unregulated products — it is a direct path to serious, potentially permanent, potentially fatal lung injury. EVALI is the visible tip of a much larger iceberg. The long-term effects of vaping on lung function, cardiovascular health, brain development, and cancer risk are still being studied — because the products are too new for us to know the full picture yet. What we do know is alarming enough to act on now. The Cayman Islands has the information, the institutions, and the community will to get ahead of this. CI Mavericks is proud to be part of that conversation.
“A coordinated multidisciplinary approach, involving clinicians, public health officials, and policymakers, is warranted to mitigate the risks and promote safer practices.”
— Thapa, Paudyal, Somji, Sharma, Surani — Journal of Independent Medicine, 2026