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It's caused by irritation from smoke, not by a virus or bacteria

Recently, I cared for a young woman in her 20s who was admitted to the intensive care unit at Huntington Hospital with what was believed to be a case of vape-related lung disease

This can allow an electric current to pass to the tissues of the gastrointestinal tract in case of ingestion, resulting in a current-induced severe necrosis with tissue damage and even perforation of the oropharynx, oesophagus, stomach or small intestine 27

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Employment status was also found to be a significant predictor, smokers who were students (95% CI 0.5220.917), housewives (95% CI 0.6060.895), or unemployed with income (95% CI 0.6970.923) smoked 31.7%, 25.8%, and 19.6% fewer the number of cigarettes than those who were unemployed, respectively