Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May;116(5):985-993.
doi: 10.1111/add.15108. Epub 2020 May 30.

Lessons from the public health responses to the US outbreak of vaping-related lung injury

Wayne Hall  1 , Coral Gartner  2 , Billie Bonevski  3
Affiliations

Lessons from the public health responses to the US outbreak of vaping-related lung injury

Wayne Hall et al. Addiction. 2021 May.

Abstract

Aim: To describe an outbreak of lung injuries in 2019 among people who vaped in the United States (type of injuries, people afflicted, substances vaped and cause of the injuries) and to analyse critically the regulatory responses of public health authorities and the media reporting of the outbreak.

Methods: Case studies of the reporting of the e-cigarette or vaping product use associated lung injury (EVALI) outbreak. We examined data on the number of cases of lung injury provided by the US Centers for Disease Control (CDC), public advice on the causes of the outbreak provided by the CDC and the Food and Drug Administration (FDA), major media reports of the outbreak and proposed regulatory responses by governments in the United States, Australia and the United Kingdom.

Results: The CDC initially suggested that the cause of the outbreak was nicotine vaping because the outbreak followed a large increase in nicotine vaping among US adolescents. Case-control studies revealed that the majority of cases had vaped illicit cannabis oils that were contaminated by vitamin E acetate. The CDC's public advice and the media were slow to report the evidence on the role of cannabis vaping. Popular government regulatory proposals-bans on sales of nicotine flavours and vaporizers-were based on the assumption that nicotine vaping was the cause of the outbreak.

Conclusions: Media reporting in the United States, Australia and the United Kingdom of the US Centers for Disease Control's analysis of the causes of the e-cigarette or vaping product use associated lung injury outbreak contributed to regulatory over-reactions to nicotine vaping by the public health community.

Keywords: Cannabis legalisation; cannabis vaping; e-cigarette bans; e-cigarettes; vaping related lung injury; vitamin E acetate.

PubMed Disclaimer

Comment in

References

    1. US Centers for Disease Control and Prevention (CDC). CDC, States Investigating Severe Pulmonary Disease Among People Who Use E-Cigarettes: Media Statement for Immediate Release: Saturday, August 17; 2019. Available at: https://www.cdc.gov/media/releases/2019/s0817-pulmonary-disease-ecigaret....
    1. Layden J. E., Ghinai I., Pray I., Kimball A., Layer M., Tenforde M., et al. Pulmonary illness related to e-cigarette use in Illinois and Wisconsin-preliminary report. N Engl J Med 2019; 382: 903-916.
    1. Siegel D. A., Jatlaoui T. C., Koumans E. H., Kiernan E. A., Layer M., Cates J. E., et al. Update: interim guidance for health care providers evaluating and caring for patients with suspected e-cigarette, or vaping, product use associated lung injury-United States, October 2019. Morb Mortal Wkly Rep 2019; 68: 919-927.
    1. Schier J. G., Meiman J. G., Layden J., Mikosz C. A., VanFrank B., King B. A., et al. Severe pulmonary disease associated with electronic-cigarette-product use-interim guidance. Morb Mortal Wkly Rep 2019; 68: 787-790.
    1. US Centers for Disease Control and Prevention (CDC). States Update Number of Hospitalized EVALI Cases and EVALI Deaths: Media Statement for Immediate Release: Thursday, January 9, 2020. Atlanta, GA: Centres for Disease Control and Prevention; 2020 Available at: https://www.cdc.gov/media/releases/2020/s0109-evali-cases.html (accessed 10 January 2020).

LinkOut - more resources