Across the United States, there have been reports of severe lung illnesses and deaths associated with vaping and e-cigarette use. The specific cause of the illness is not known. There have been over one thousand confirmed cases throughout the U.S., including several in Washington state.

E-cigarettes are devices that produce an aerosol by heating a liquid with many chemicals. Users inhale the aerosol and other chemicals into their lungs. There are over 60 inhaled chemicals including:

• nicotine
  
• tetrahydrocannabinol (THC, the psychoactive component in cannabis/marijuana)
  
• cannabidiol (CBD, another chemical found in cannabis/marijuana)
• flavorings and other additives like heavy metals and oils

E-cigarette use is referred to as "vaping" because the liquid solution becomes a vapor when it is inhaled.

• E-cigarettes and vaping are not safe. Avoid using e-cigarettes and vaping until the cause of this outbreak is known.
• Talk to your kids about the risks of vaping.
• Seek medical attention if you experience coughing, shortness of breath, chest pain, nausea or fatigue and use e-cigarette products.
• Do not buy e-cigarette products off the street or modify them.
• Youth, young adults, pregnant women, and adults who do not currently use tobacco products should not use e-cigarettes.

Adults and youth who want to quit should talk to their doctor about treatments, including counseling and FDA-approved medications. If you want to stop using e-cigarettes, or any tobacco product, you can call the Quitline at 1-800-QUIT-NOW.

If you have already switched to e-cigarettes, talk to your health care provider or contact the Quitline at 1-800-QUIT-NOW to discuss other treatment options like counseling and FDA-approved medications. The CDC recommends that adults who used e-cigarettes to quit smoking do not return to smoking cigarettes.

We do not know yet what causes this illness. Many, but not all, patients who developed this illness report that, in addition to nicotine, they vaped pre-filled cartridges of cannabis-derivative products like THC or CBD.

We do not know yet. Testing at several national labs has identified a compound – Vitamin E acetate – in some, but not all, of the THC product samples collected from people who became sick. However, we do not know if Vitamin E acetate was the cause, or even one of several causes, of the illness. There is also no way for you to test if a product you purchase contains Vitamin E acetate or any other possibly harmful chemical.

No product has yet been identified as safe, and there is no evidence to date that any set of ingredients or extraction techniques prevent this illness. Additionally, information about ingredients or extraction techniques listed on packaging may not be accurate. Ingredients that may be safe when eaten or applied to skin may not be safe when vaporized or inhaled.