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EVALI (Vape Lung)

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EVALI (Vape Lung)—E-Cigarette or Vaping Product Use-Associated Lung Injury

Using electronic cigarettes, also called vaping or juuling, can be dangerous. There are many risks associated with vaping, regardless of which vaping device or e-liquid you use. There are many different nicotine, THC and CBD solutions of various concentrations, plus added chemicals and/or flavors, and none have been established as safe to breathe into your lungs. This fact sheet reviews information about EVALI–vaping related lung injuries.

In 2019, health care providers began to notice a growing number of health concerns associated with vaping, including very serious lung problems. These problems also have been called “Vaping Associated Pulmonary Illness (VAPI)” or Vape Lung. Since that time, the Centers for Disease Control (CDC) investigated and reported on hundreds of cases of EVALI across over 30 states. Some people have died from EVALI, while others have become very sick, and required treatment in the intensive care unit (ICU) to recover. EVALI has been reported with use of nicotine, tetrahydrocannabinol (THC) and cannabidiol (CBD) products. Though the exact cause of vape lung is still not known, Vitamin E added to the vape devices has been associated with EVALI. However, there are still cases of EVALI that are not associated with Vitamin-E-containing products.

Symptoms of EVALI (Vape Lung) can include:

  • Shortness of breath
  • Fever
  • Cough
  • Vomiting
  • Diarrhea
  • Headache
  • Dizziness
  • Chest pain

If you vape and have any of these symptoms, contact your health care provider.

Key Points about Vaping

  • Avoid use of electronic (e)-cigarettes and other vaping devices.
  • Always keep all e-cigarette and vaping devices, including concentrated nicotine, THC and CBC solutions out of reach of children.
  • If you are trying to stop smoking or vaping, talk with your health care provider about safe and effective medicines to treat nicotine addiction and to help you to feel comfortable when not smoking/vaping or using tobacco.
  • For additional help in stopping smoking or vaping, join a local support group, call QUITNOW, or visit the Truth Initiative Website or tobaccofree.org/resources.

Authors: W. Graham Carlos, MD; Laura E. Crotty Alexander, MD; Jane E. Gross MD, PhD; Charles S. Dela Cruz MD, PhD; Jonathan M Keller, MD; Susan Pasnick, MD; Shazia Jamil, MD

Reviewers: Marianna Sockrider MD, DrPH; Frank Leone, MD; Michelle Eakin, PhD; and Hasmeena Kathuria, MD

Am J Respir Crit Care Med Vol. 200, P15, 2019

Online version updated April 2025

ATS Patient Education Series © 2019 American Thoracic Society

This information is a public service of the American Thoracic Society. The content is for educational purposes only. It should not be used as a substitute for the medical advice of one’s healthcare provider.