The Centers for Disease Control and Prevention (CDC) is working with the Food and Drug Administration, state health departments and public health and clinical partners to investigate the multistate outbreak of lung injury associated with e-cigarette product use, or vaping.
- Recent CDC laboratory testing of biologic samples from 29 patients with EVALI submitted to CDC from 10 states found vitamin E acetate in all of the BAL fluid samples. THC was identified in 82% of the samples and nicotine was identified in 62% of the samples.
- CDC tested for a wide range of substances found in e-cigarette, or vaping, products, including plant oils, petroleum distillates like mineral oil, medium-chain triglyceride oil (MCT oil), and terpenes, which are compounds found in or added to THC products. No other chemicals were detected.
- These findings provide direct evidence of vitamin E acetate within the lungs at the primary site of injury. This is the first time we have detected a potential chemical of concern in biologic samples from patients with EVALI.
- Our findings still do not rule out other possible compounds or ingredients that may be contributing to these lung injuries.
- This work complements the ongoing work of FDA and some state public health laboratories to characterize e-liquid exposures. It also highlights the extensive collaboration between federal, state, and local partners.
Risk Factors for E-Cigarette, or Vaping, Product Use Associated Lung Injury (EVALI) Among Adults Who Use E-Cigarette, or Vaping, Products— Illinois, July-October 2019
- In Illinois, E-cigarette, or vaping, product use behaviors of 66 patients with these lung injuries aged 18–44 years who were interviewed as part of the ongoing outbreak investigation were compared with a subset of 519 survey respondents aged 18–44 years who reported use of THC-containing e-cigarette, or vaping, products. These findings suggest that compared to adult survey respondents who reported use of THC-containing products and had not developed lung injury, EVALI patients were more likely to report:
- Obtaining THC-containing e-cigarette, or vaping, products through informal sources (e.g. a dealer, a friend, or off the street);
- Using e-cigarette, or vaping, products more than five times per day;
- Using a THC-containing product called Dank Vapes; and
- Using THC-containing products exclusively.
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What You Need to Know
- As of November 5, 2019, 2,051 lung injury cases associated with use of e-cigarette, or vaping, products have been reported to CDC from the District of Columbia, one U.S. territory (USVI) and 49 states (all except Alaska).
- 39 deaths have been confirmed in 24 states.
- CDC recommends that people should not:
- Use e-cigarette, or vaping, products that contain THC.
- Buy any type of e-cigarette, or vaping, products, particularly those containing THC, from informal sources such as from friends, family, or in-person or online dealers.
- Modify or add any substances to e-cigarette, or vaping, products that are not intended by the manufacturer, including products purchased through retail establishments.
- Since the specific compound or ingredient causing lung injury is not yet known, the only way to assure that you are not at risk while the investigation continues is to consider refraining from use of all e-cigarette, or vaping, products.
- Adults using e-cigarettes to quit smoking should not go back to smoking; they should weigh all risks and benefits and consider utilizing FDA-approved nicotine replacement therapies.
- CDC continues to refine recommendations based on emerging data. Update information and recommendations can be found at: www.cdc.gov/lunginjury
What’s New on the Lung Injury Response Website This Week:
- Updated case counts, death counts, a map of states reporting cases, and a graph of case counts over time
- The following resources are available in Spanish:
Request for State and Local Health Department Partners
- Has your jurisdiction created tailored materials for young adults and/or parents/caregivers about the signs, symptoms, and behaviors associated with e-cigarette, or vaping, product use associated lung injury?
- Are you willing to share those materials with others through the weekly partner update and on the CDC Lung Injury website?
- If you answered yes to either of these questions, we’d love to hear from you at firstname.lastname@example.org.
The most up-to-date, publicly available information can be found at: www.cdc.gov/lunginjury