Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping

CDC, the U.S. Food and Drug Administration (FDA), state and local health departments, and other clinical and public health partners are investigating a multistate outbreak of lung injury associated with use of e-cigarette, or vaping, products.

What we know

As of October 8, 2019, 1,299* lung injury cases associated with the use of e-cigarette, or vaping, products have been reported to CDC from 49 states, the District of Columbia, and 1 U.S. territory.
Twenty-six deaths have been confirmed in 21 states.
All patients have reported a history of using e-cigarette, or vaping, products.
Most patients report a history of using tetrahydrocannabinol (THC)-containing products. The latest national and state findings suggest products containing THC, particularly those obtained off the street or from other informal sources (e.g. friends, family members, illicit dealers), are linked to most of the cases and play a major role in the outbreak.
Therefore, CDC recommends that you should not use e-cigarette, or vaping, products that contain THC.
Exclusive use of nicotine containing products has been reported by some patients with lung injury cases, and many patients with lung injury report combined use of THC- and nicotine-containing products. Therefore, the possibility that nicotine-containing products play a role in this outbreak cannot be excluded.
At present, CDC continues to recommend that people consider refraining from using e-cigarette, or vaping, products that contain nicotine.

What we don’t know
What CDC recommends
At this time, FDA and CDC have not identified the cause or causes of the lung injuries in these cases, and the only commonality among all cases is that patients report the use of e-cigarette, or vaping, products.
This outbreak might have more than one cause, and many different substances and product sources are still under investigation. The specific chemical exposure(s) causing lung injuries associated with e-cigarette product use, or vaping, remains unknown at this time

What CDC recommends
CDC recommends that people:
- Should not use e-cigarette, or vaping, products that contain THC.
- Should not buy any type of e-cigarette, or vaping, products, particularly those containing THC, off the street.
- Should not modify or add any substances to e-cigarette, or vaping, products that are not intended by the manufacturer, including products purchased through retail establishments.
At present, CDC continues to recommend that people consider refraining from using e-cigarette, or vaping, products that contain nicotine.
If you are an adult using e-cigarette, or vaping, products to quit cigarette smoking, do not return to smoking cigarettes. Use evidence-based treatments, including healthcare provider counseling and FDA approved medicationspdf iconexternal icon.
If you have recently used an e-cigarette or vaping product, see a healthcare provider immediately if you develop symptoms like those reported in this outbreak.
Regardless of the ongoing investigation:
- E-cigarette, or vaping, products should never be used by youths, young adults, or women who are pregnant.
- Adults who do not currently use tobacco products should not start using e-cigarette, or vaping, products.
- THC use has been associated with a wide range of health effects, particularly with prolonged heavy use. The best way to avoid potentially harmful effects is to not use THC, including through e-cigarette, or vaping, products. Persons with marijuana use disorder should seek evidence-based treatment by a health care provider.
- There is no safe tobacco product, and the use of any tobacco products, including e-cigarettes, carries a risk.
- CDC will continue to update guidance, as appropriate, as new data emerges from this complex outbreak.

Key Facts about E-Cigarette Use, or Vaping

Electronic cigarettes – or e-cigarettes — are also called vapes, e-hookahs, vape pens, tank systems, mods, and electronic nicotine delivery systems (ENDS).
Using an e-cigarette product is commonly called vaping.
E-cigarettes work by heating a liquid to produce an aerosol that users inhale into their lungs.
The liquid can contain: nicotine, tetrahydrocannabinol (THC) and cannabinoid (CBD) oils, and other substances and additives. THC is the psychoactive mind-altering compound of marijuana that produces the “high”.