EVALI: What you need to know

September 11, 2020

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Last updated: 8/23/20

UPDATE:

  • Eight new EVALI cases were reported in California during April 2020, including one fatality.
  • Preliminary research outlined in a letter to the editor of the American Journal of Respiratory and Critical Care Medicine identifies a chemical, ethenone, as a potential culprit behind non-vitamin E acetate EVALI cases.

In 2019, a sudden and severe lung illness from vaping affected over a thousand people in the US1, becoming a public health crisis. All patients were hospitalized, with treatments including medically induced comas,2,3 breathing machines4, and other life support measures.5

Patients experienced a range of warning signs before going to the hospital. Doctors treated patients with many different symptoms, from trouble breathing6 to lung damage that looks like chemical burns.7 The exact cause of the outbreak is unknown,8 but here’s what we do know:

  • 2,801 cases of vaping lung illnesses are reported so far, across 50 states and Washington DC and two US territories 9, including more than 200 cases in California.10
  • 68 vaping deaths have been confirmed nationwide, including five in California.11,12
  • Products containing THC, especially those obtained off the street or from other informal sources (for example, friends, family members, or illegal dealers) are linked to most of the cases and play a major role in the outbreak. However, the liquids in vape devices associated with the lung illness include nicotine, THC, and CBD. Many people say they vape both cannabis and nicotine. 13,14
  • A third of the patients need breathing machines to keep them alive.15
  • Average patient age is 24 years old. 16
  • Most are men.17

For reports on California outbreak information, visit California Department of Public Health and download the EVALI Update Report.

People with lung damage from vaping usually show signs that start a few days to a few weeks before they go see a doctor.18 All people hospitalized had some type of breathing problem, but many people also have other symptoms. The warning signs reported by those affected are:

  • Cough, shortness of breath, or chest pain
  • Nausea, throwing up, stomach pain, or diarrhea
  • Fatigue, fever, or unexplained weight loss

If you vape and are experiencing any of these symptoms, please see a doctor. Keep in mind, you don’t have to be a long-time user in order to develop the lung illness. New users have been affected as well. 19,20

CDPH urges everyone to quit vaping altogether, no matter the substance or source. Need help quitting? Call 1-844-8-NO-VAPE or CHAT NOW. For additional resources go to NoButts.org.

In addition to the danger of EVALI, growing evidence suggests that the aerosol from vaping devices can harm lungs at the cellular and organ levels and worsen the body’s ability to fight respiratory infections.21 If you smoke or vape and get the COVID-19 virus, you increase your risk of developing more severe COVID-19 symptoms.

Get more EVALI information from the CDC.

Read more about the negative health effects of vaping:

References renameme

  1. Centers for Disease Control and Prevention. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. cdc.gov. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Updated February 25, 2020. Accessed October 17, 2019.
  2. Steinbrecher L. Nephi Teen Says Vaping Put Her in a Coma, Worst Case Doctors Had Seen. fox13now.com. fox13now.com/2019/08/27/nephi-teen-says-her-vaping-put-her-in-a-coma-worst-case-doctors-had-seen/. Published August 27, 2019. Accessed August 4, 2020.
  3. Edwards E, Dunn L. 22 People Have Been Hospitalized with Vaping-Linked Breathing Problems. Doctors Don't Know Why. NBCNews.com. www.nbcnews.com/health/vaping/22-people-have-been-hospitalized-vaping-linked-breathing-problems-doctors-n1041851. Published August 13, 2019. Accessed August 4, 2020.
  4. California Department of Public Health. Vaping Associated Lung Injury (EVALI). cdph.ca.gov. www.cdph.ca.gov/Programs/CCDPHP/Pages/Vaping-Health-Advisory.aspx. Updated July 16, 2020. Accessed August 4, 2020.
  5. California Department of Public Health. Vaping Associated Lung Injury (EVALI). cdph.ca.gov. www.cdph.ca.gov/Programs/CCDPHP/Pages/Vaping-Health-Advisory.aspx. Updated July 16, 2020. Accessed August 4, 2020.
  6. Centers for Disease Control and Prevention. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. cdc.gov. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Updated February 25, 2020. Accessed October 17, 2019.
  7. Butt YM, Smith ML, Tazelaar HD, et al. Pathology of Vaping-Associated Lung Injury. N Engl J Med. 2019;381(18):1780-1781. doi:10.1056/NEJMc1913069
  8. Centers for Disease Control and Prevention. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. cdc.gov. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Updated February 25, 2020. Accessed October 17, 2019.
  9. Centers for Disease Control and Prevention. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. cdc.gov. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Updated February 25, 2020. Accessed October 17, 2019.
  10. California Department of Public Health. Vaping Associated Lung Injury (EVALI). cdph.ca.gov. www.cdph.ca.gov/Programs/CCDPHP/Pages/Vaping-Health-Advisory.aspx. Updated July 16, 2020. Accessed August 4, 2020.
  11. California Department of Public Health. Vaping Associated Lung Injury (EVALI). cdph.ca.gov. www.cdph.ca.gov/Programs/CCDPHP/Pages/Vaping-Health-Advisory.aspx. Updated July 16, 2020. Accessed August 4, 2020.
  12. California Department of Public Health. Vaping Associated Lung Injury (EVALI). cdph.ca.gov. www.cdph.ca.gov/Programs/CCDPHP/Pages/Vaping-Health-Advisory.aspx. Updated July 16, 2020. Accessed August 4, 2020.
  13. Centers for Disease Control and Prevention. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. cdc.gov. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Updated February 25, 2020. Accessed October 17, 2019.
  14. Centers for Disease Control and Prevention. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. cdc.gov. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Updated February 25, 2020. Accessed October 17, 2019.
  15. https://www.cdph.ca.gov/Programs/CCDPHP/Pages/Vaping-Health-Advisory.aspx
  16. https://www.cdc.gov/mmwr/volumes/69/wr/mm6925a5.htm?s_cid=mm6925a5_w
  17. Centers for Disease Control and Prevention. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. cdc.gov. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Updated February 25, 2020. Accessed October 17, 2019.
  18. Centers for Disease Control and Prevention. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. cdc.gov. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Updated February 25, 2020. Accessed October 17, 2019.
  19. For the Public: What You Need to Know. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease/need-to-know/index.html. Accessed October 17, 2019.
  20. Centers for Disease Control and Prevention. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. cdc.gov. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Updated February 25, 2020. Accessed October 17, 2019.
  21. Gotts JE, Jordt SE, McConnell R, Tarran R. What are the respiratory effects of e-cigarettes? BMJ. 2019;366:l5275.

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