I’m not sure. She lives 1000 miles away, and the last time I saw her she was pretending to be smoke free, but I saw her vaping in the backyard.
She is on constant oxygen and several expensive inhalers.
I don’t mean to be a jerk, but it really sounds like your sister has some significant lung issues—emphysema, cancer, or something. People toss out the COPD word when they either don’t want to tell you what’s wrong...or they don’t want to know.
Someone with COPD should not be inhaling anything but air. If she is on constant O2, you might want to have a conversation with her—because she is not going to be around a lot longer.
Vaping, smoking....it doesn’t matter. The damage is done. Don’t point the blame anywhere beyond her behavior.