EVALI: What you need to know

June 19, 2020

Last updated: 2/26/20

A sudden and severe lung illness from vaping has affected over a thousand people in the US1, becoming a public health crisis. Nearly all patients have been hospitalized, receiving treatments including medically induced coma2 3 4 breathing machines5, and other life support measures.6 7 8

Patients experience a range of warning signs before going to the hospital. Doctors have treated patients with many different symptoms, from trouble breathing9 to lung damage that looks like chemical burns.10 The exact cause of the outbreak is unknown,11 but here’s what we do know:

  • 2,807 cases of vaping lung illnesses are reported so far, across 50 states12, including more than 200 cases in California.13
  • 68 vaping deaths have been confirmed nationwide, including four in California.14 15
  • 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. 16 17
  • A third of the patients need breathing machines to keep them alive.18
  • Two-thirds are between 18-34 years old. 15
  • Most are men.20

For an updated weekly report on California outbreak information, visit California Department of Public Health and download the EVALI Weekly 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.21 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. 22 23

Need help quitting? Call 1-844-8-NO-VAPE or CHAT NOW. For additional resources go to NoButts.org.

CDPH strongly recommends that you stop vaping until the cause of the lung illness is known. For those who choose to vape THC, only buy products from a licensed cannabis store. Never buy any type of e-cigarette or vaping product off the street, especially those that have THC. Never modify a vape product.

CDC additionally recommends Vitamin E acetate should not be added to any e-cigarette, or vaping, products. People should not add any other substances not intended by the manufacturer to products, including products purchased through retail establishments

Officials are concerned about whether the vaping illness increases the risk of the flu or other illnesses during or following treatment. CDC recommends everyone six months of age and older should get a flu vaccine every year by the end of October, including people who use e-cigarette, or vaping, products.24

Get more outbreak information from the CDC.

Additional resources:

References renameme

  1. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Accessed October 17, 2019.
  2. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Accessed October 17, 2019.
  3. Steinbrecher, Lauren. “Nephi Teen Says Vaping Put Her in a Coma, Worst Case Doctors Had Seen.” Nephi Teen Says Vaping Put Her in a Coma, Worst Case Doctors Had Seen, Fox, 28 Aug. 2019, fox13now.com/2019/08/27/nephi-teen-says-her-vaping-put-her-in-a-coma-worst-case-doctors-had-seen/.
  4. Edwards, Erika, and Lauren Dunn. “22 People Have Been Hospitalized with Vaping-Linked Breathing Problems. Doctors Don't Know Why.” NBCNews.com, NBCUniversal News Group, 5 Sept. 2019, www.nbcnews.com/health/vaping/22-people-have-been-hospitalized-vaping-linked-breathing-problems-doctors-n1041851.
  5. Jensen, Thor. “Doctors Blame Vaping for Mysterious Illness That Put Man in Medically Induced Coma.” Newsweek, Newsweek, 4 Sept. 2019, www.newsweek.com/vaping-medically-induced-coma-1457669.
  6. “Vaping Health Advisory.” Vaping Health Advisory, 15 Oct. 2019, www.cdph.ca.gov/Programs/CCDPHP/Pages/Vaping-Health-Advisory.aspx.
  7. “Vaping Health Advisory.” Vaping Health Advisory, 15 Oct. 2019, www.cdph.ca.gov/Programs/CCDPHP/Pages/Vaping-Health-Advisory.aspx.
  8. Iati, Marisa. “Her Temperature Spiked the Day She Decided to Stop Vaping. Now She's on Life Support.” The Washington Post, WP Company, 12 Sept
  9. https://www.insider.com/vaping-lung-injury-almost-kills-man-who-vaped-every-day-2019-8
  10. https://www.cdph.ca.gov/Programs/CCDPHP/CDPH%20Document%20Library/California%20Department%20of%20Public%20Health%20-%20Health%20Advisory%20September%2024,%202019.pdf
  11. Grady, Denise. “Lung Damage From Vaping Resembles Chemical Burns, Report Says.” The New York Times, The New York Times, 2 Oct. 2019, www.nytimes.com/2019/10/02/health/vaping-illnesses.html.
  12. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Accessed October 17, 2019.
  13. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Accessed October 17, 2019
  14. “Vaping Health Advisory.” Vaping Health Advisory, 15 Oct. 2019, www.cdph.ca.gov/Programs/CCDPHP/Pages/Vaping-Health-Advisory.aspx.
  15. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Accessed October 17, 2019
  16. “Vaping Health Advisory.” Vaping Health Advisory, 15 Oct. 2019, www.cdph.ca.gov/Programs/CCDPHP/Pages/Vaping-Health-Advisory.aspx.
  17. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Accessed October 17, 2019.
  18. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Accessed October 17, 2019
  19. https://www.cdph.ca.gov/Programs/CCDPHP/Pages/Vaping-Health-Advisory.aspx
  20. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Accessed October 17, 2019
  21. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Accessed October 17, 2019.
  22. 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. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease/need-to-know/index.html
  23. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Accessed October 17, 2019.
  24. Vaping Health Advisory.” Vaping Health Advisory, 15 Oct. 2019, www.cdph.ca.gov/Programs/CCDPHP/Pages/Vaping-Health-Advisory.aspx.
  25. 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. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease/need-to-know/index.html