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This story was updated most recently Dec. 5, 2019 with new cases of vaping-related illness.

Sept. 26, 2019 -- Forty-eight people have died due to vaping-related illness in the U.S.

Also, the outbreak has now hit all 50 states, as Alaska became the last one to announce a case related to the vaping outbreak.

The CDC has identified vitamin E acetate as the first "chemical of concern" in e-cigarettes. Its used as a thickening agent in vapes wtih THC and was found in all lung fluid samples in 29 patients from 10 states. 

Illinois is the first state to have five deaths. New York reported its second death, a male in his 30s who had a history of vaping, as did Missouri, a woman in her mid 50s.

Recently Louisiana reported its first death and California, Illinois and Indiana recently reported their fourth deaths. 

In California, the death was of a Marin County woman in her 40s who was previously healthy and had started vaping six months ago. No details were given on the other cases.

As cases climb, more states have sought to enact some type of ban on e-cigarettes. Some are being challenged in court. On Nov. 5, a judge in Rhode Island upheld that state's temporary ban on flavored e-cigarettes. But courts in New YorkMichigan, Montana, Utah and Oregon have blocked similar bans. Massachusetts' ban on all e-cigarettes may be changed by court order to exempt medical marijuna. Washington state has a ban on flavored e-cigarettes and Ohio has banned the sale of any tobacco products to anyone under 21. Voters upheld a ban in San Francisco of all vaping products.  

The Trump administration backed off a request asking the FDA to ban the sale of non-tobacco-flavored e-cigarettes. President Donald Trump said he needed more time to investigate the issue. 

Cases of vaping-related lung illness in the U.S. have climbed to 2,291 as of Dec. 4. Patients who have got sick range in age from 13 to 78, with a median age of 24. Fifteen percent of those who have become ill are younger than 18, the CDC says. The majority of cases of vaping-related illness are in men under 35 years old. 

The confirmed cases are from 50 states, the District of Columbia and two territories. The deaths are from 25 states and the District of Columbia.

The patients who died range in age from 17 to 75 years old, the CDC said, with the median age 52 years. Patients who died were older than patients who survived. 

CDC data on 19 of the people who died shows that 84% reported some use of THC, the ingredient in marijuana that makes users high, and 63% used it exclusively. Thirty-seven precent reported any use of nicotine-containing products, including 16% who used nicotine-containing products exclusively. The CDC has named the illness EVALI, which stands for e-cigarette or vaping product use associated lung injury.

"The latest national and state findings suggest THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, or family, or in-person or online dealers, are linked to most of the cases and play a major role in the outbreak," the CDC said.

Patients  with EVALI typically report coughing, shortness of breath, chest pain, nausea, vomiting, diarrhea, fever, and belly pain.

On Sept. 30, Texas chain H-E-B said it had immediately discontinued sales of e-cigarettes. Walmart, the world's largest retailer, said it would stop selling all e-cigarettes once existing inventory runs out, CNBC reported this month.

“Given the growing federal, state and local regulatory complexity and uncertainty regarding e-cigarettes, we plan to discontinue the sale of electronic nicotine delivery products at all Walmart and Sam’s Club U.S. locations,” the company said in a memo to local managers. “We will complete our exit after selling through current inventory.”

New data reveal the rate of vaping nicotine among teens has doubled in the past 2 years. According to the 2019 Monitoring the Future Survey, 25% of 12th graders, 20% of 10th graders, and 9% of eighth graders reported vaping nicotine in the past month.

For its investigation, the FDA has collected more than 150 vaping product samples, according to Mitch Zeller, JD, director of the FDA Center for Tobacco Products. The agency is analyzing the samples for a broad range of substances, including THC and other cannabinoids, opioids, cutting agents, pesticides, and other toxins.

The FDA's enforcement arm -- the Office of Criminal Investigations -- has begun a parallel investigation, Zeller said. It will focus on the supply chain and figuring out what is making people sick.

He didn’t know when federal officials might determine which product or products are to blame.

"Identifying any product in the samples is just one piece of the puzzle," he said.

Emerging Profile

A growing number of media companies are shunning vaping advertisements. Following the lead of CNN, which announced it will no longer run ads for vaping products, CBS, WarnerMedia, and Viacom are also pulling the plug on e-cigarette advertising.

Meanwhile, the CEO of Juul Labs, the largest vaping product maker in the United States, announced he was stepping down and the company said it would stop all advertising. Kroger and Walgreens have also stopped sales of e-cigarettes. Learn more about teens using Juul.

Federal officials again pleaded for people to stop vaping until they know more about what is triggering the lung injuries.

Anyone with information is urged to report it to the online safety reporting portal for the FDA and National Institutes of Health, Zeller said, at

WebMD Health News


Briefing, CDC, Sept. 19, 2019.

National Institute on Drug Abuse: “Researchers sound alarm on potential health effects of vaping.”

CNBC: “CBS, WarnerMedia, Viacom drop all e-cigarette advertising, including from market leader Juul.”

CNBC: "Walmart will stop selling e-cigarettes in the wake of vaping-related deaths."

Kansas Department of Health and Environment. 

Department of Health State of Florida, "Lung Injury Associated with E-Cigarette Use, or Vaping* - Florida."

Georgia Department of Public Health, "DPH Identifies First Death From Vaping-Associated Illness."

Mississippi State Department of Health, "Health Officials Report First Death Related to Vaping in Mississippi."

Nebraska Department of Health and Human Services. 

NewsWest9: " H-E-B discontinues the sale of e-cigarettes."

Virginia Department of Health.

Alabama Public Health., news release.

Delaware Division of Public Health. 

Connecticut Department of Public Health. 

Pennsylvania Department of Health. 

Massachusetts Department of Public Health.

New York State.

ABC news: "Judge blocks Michigan's ban on flavored e-cigarettes."

Montana Department of Public Health and Human Services.

Tennessee Department of Health.

Indiana State Department of Health.

News release,

MMWR: "Update: Characteristics of Patients in a National Outbreak of E-cigarette, or Vaping, Product Use–Associated Lung Injuries — United States, October 2019."

Fox13: "Judge overturns ban on sale of flavored vape juices."

Forbes: "Juul Sales To Cease In San Francisco After Voters Uphold Vaping Ban."

News 5: "American Lung Association calls Ohio's new vaping law "meaningless" due to enforcement loopholes."

U.S. News & World Report: "Montana Judge Halts Temporary Flavored Vaping Ban."

Oregonlive: "Oregon appeals court halts governor’s vaping ban on flavored tobacco products."

CNN: "Washington state has banned the sale of flavored vaping products."

Boston Herald: "Lift on Massachusetts medical marijuana vape ban a ‘big victory’ for patients."

USA Today: "Judge temporarily halts flavored vape ban in Michigan, cites harm to businesses."

Albany Times Union: "Health groups file brief supporting NY flavored vape ban."

Providence Journal: "Judge allows Raimondo’s ban on flavored vapes to stand."

News release, Marin Health & Human Services.

Louisiana Department of Health.

Alaska Department of Health and Social Services.





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