Most EVALI Patients used THC-Containing Products

The Centers for Disease Control and Prevention (CDC) has released two reports on e-cigarette, or vaping, product use–associated lung injury (EVALI), confirming that most EVALI patients report using tetrahydrocannabinol (THC)-containing products and that new EVALI cases have continued to decline with time.  The two reports appear in CDC’s Morbidity & Mortality Weekly Report (MMWR). The first MMWR report updates EVALI patient demographic and self-reported substance use characteristics. As of January 14, 82% of EVALI patients nationwide with available data reported using any THC-containing e-cigarette, or vaping, products, and 57% reported using any nicotine-containing products; 33% reported exclusive THC-containing product use, and 14% reported exclusive nicotine-containing product use.  The report also analyzed updated data on newly reported cases to CDC, as well as emergency department visits over time related to e-cigarette, or vaping, products. These data show that the EVALI outbreak began in June 2019 and peaked in September 2019. The number of cases has since continued to decline, but new cases and deaths continue to be reported. The second MMWR report summarizes characteristics of EVALI patients in Illinois by substances used in e-cigarette, or vaping, products. The study found that while most Illinois EVALI patients reported use of THC-containing products, a small percentage had no evidence of any use of THC-containing e-cigarette, or vaping, products.  Of 121 interviewed EVALI patients in Illinois, nine reported using only nicotine-containing products and had no indication of any THC use. These patients were more likely to be older and female than patients who reported using THC-containing products. These findings support earlier data suggesting that while THC containing e-cigarette, or vaping, products and vitamin E acetate play a major role in the outbreak, evidence is not sufficient to rule out the contribution of other chemicals of concern, including chemicals in either THC or non-THC products, in some of the reported EVALI cases.