WASHINGTON: US public health officials are investigating more than 450 cases of severe lung illnesses and have confirmed at least five deaths related to electronic cigarette products including the devices and liquids used inside them.
The Centres for Disease Control and Prevention defines e-cigarettes as devices that deliver an aerosol to the user by heating a liquid that usually contains nicotine, flavourings and other chemicals. E-cigarettes can also be used to deliver marijuana or other substances.
WHAT WE KNOW
As of Sep 6, the CDC has received reports of cases from 33 states and the US Virgin Islands. The CDC has confirmed deaths related to vaping or e-cigarette use in California, Illinois, Indiana, Minnesota and Oregon.
The CDC is studying use of both nicotine and tetrahydrocannabinol or THC, the psychoactive component of cannabis, to determine the cause.
Although the illness can cause a fever and other symptoms that suggest an infection, patients do not respond to antibiotics, and doctors believe they are suffering from a chemical injury.
WHAT WE DO NOT KNOW
So far, no single product has been identified in all of the cases. The only common thread so far is that people who had lung illnesses used e-cigarettes or vaping devices.
It is not yet clear whether the illness is unique to the United States, though some health agencies, such as Canada's, say they have not had any cases so far.
The CDC is also investigating whether the illnesses are caused by ingredients in the vaping products or by vaping habits in general.
WHAT STAKEHOLDERS SAY
The CDC urges consumers to refrain from all vaping until a cause is identified to avoid more patient deaths and illnesses.
The Food and Drug Administration has warned consumers to avoid vaping products purchased outside of retail stores in the US as well as THC liquids or other illicit substances.
In a warning issued on Sep 6, the agency stressed that many samples of vaping liquids used by patients contained THC and that most samples with THC also contained significant amounts of Vitamin E acetate, a substance present in dietary supplements.
The American Medical Association has urged all consumers to avoid vaping.
The organisation has urged doctors to warn their patients of the potential harms of e-cigarettes and has called on the FDA to regulate vaping products.
Industry officials have sought to distance their companies from any possible safety risk, focusing on the FDA's warning regarding THC liquids.
Gregory Conley, president of the American Vaping Association, criticised the AMA for "fearmongering about nicotine vaping products" while not mentioning "the very real risks of vaping illicit THC products."
Ted Kwong, a spokesman for US market leader Juul Labs, said the company's products "do not include THC, any compound derived from cannabis, or vitamin E compounds like those found in THC products." Juul is 35 per cent owned by Altria Group.