Latest on the Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products - THC likely the cause?

Updated October 31, 2019 at 1:00 PM EDT

What We Know

About the Outbreak:

  • As of October 29, 2019, 1,888* cases of e-cigarette, or vaping, product use associated lung injury (EVALI) have been reported to CDC from 49 states (all except Alaska), the District of Columbia, and 1 U.S. territory.
    • Thirty-seven deaths have been confirmed in 24 states (as of October 29, 2019).
    • Latest outbreak information is updated every Thursday.

About Patient Exposure:

  • All EVALI patients have reported a history of using e-cigarette, or vaping, products.
    • THC is present in most of the samples tested by FDA to date, and most patients report a history of using 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.
What We Don't Know
  • 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.
  • No one compound or ingredient has emerged as the cause of these illnesses to date; and it may be that there is more than one cause of this outbreak. Many different substances and product sources are still under investigation.
What CDC Recommends
  • CDC recommends that you do not use e-cigarette, or vaping, products that contain THC.
  • CDC also recommends that people should not:
    • Buy any type of e-cigarette, or vaping, products, particularly those containing THC, off the street.
    • 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 are 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.
  • If you are an adult using e-cigarettes, or vaping, products, to quit smoking, do not return to smoking cigarettes. Adults addicted to nicotine using e-cigarettes should weigh all risks and benefits
  • If people continue to use an e-cigarette, or vaping, product, carefully monitor yourself for symptoms and see a healthcare provider immediately if you develop symptoms like those reported in this outbreak.
  • Irrespective 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. There is no safe tobacco product. All tobacco products, including e-cigarettes, carry a risk.
  • 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.
  • CDC will continue to update guidance, as appropriate, as new data emerges from this complex outbreak.