Utah EVALI investigation: 92% of hospitalized patients had used THC vaping products
Among 53 Utah patients with vaping-associated lung injury, 92% had used THC-containing products, and vitamin E acetate was found in 89% of tested THC cartridges.
Quick Facts
What This Study Found
92% of interviewed patients reported using THC-containing products, 66% used nicotine products, and 60% used both. Most THC products came from informal sources (friends, illicit dealers). Testing of THC cartridges found vitamin E acetate in 17 of 20 (85%) samples. 89% of patients were hospitalized and 49% required breathing assistance.
Key Numbers
83 patients identified; 79 chart reviews; 53 interviews; 92% used THC products; 89% of tested cartridges contained vitamin E acetate; 89% hospitalized; 49% needed breathing assistance; THC products used 1-5x/day.
How They Did This
Epidemiological investigation of 83 Utah EVALI patients. Medical chart abstractions completed for 79 patients, detailed interviews with 53, and product testing of 20 THC cartridges from 6 patients.
Why This Research Matters
This investigation was part of the evidence that ultimately linked EVALI to vitamin E acetate in illicit THC cartridges, a finding that changed both public health messaging and industry practices.
The Bigger Picture
The EVALI outbreak killed 68 people and hospitalized thousands nationwide. Utah's investigation was among the first to systematically link the injuries to THC cartridges from informal sources contaminated with vitamin E acetate.
What This Study Doesn't Tell Us
Cross-sectional investigation with self-reported exposures. Product samples available from only 6 of 53 interviewed patients. Unable to determine definitive causal agent at time of publication.
Questions This Raises
- ?How widespread is vitamin E acetate contamination in current illicit THC cartridges?
- ?Have EVALI cases declined since the cause was identified?
Trust & Context
- Key Stat:
- 89% had vitamin E acetate
- Evidence Grade:
- Moderate: systematic public health investigation with laboratory confirmation, but limited product sampling.
- Study Age:
- Published in 2019.
- Original Title:
- E-cigarette Use, or Vaping, Practices and Characteristics Among Persons with Associated Lung Injury - Utah, April-October 2019.
- Published In:
- MMWR. Morbidity and mortality weekly report, 68(42), 953-956 (2019)
- Authors:
- Lewis, Nathaniel(2), McCaffrey, Keegan, Sage, Kylie, Cheng, Chia-Jung, Green, Jordan, Goldstein, Leah, Campbell, Hillary, Ferrell, Deanna, Malan, Nathan, LaCross, Nathan, Maldonado, Alejandra, Board, Amy, Hanchey, Arianna, Harris, Dixie, Callahan, Sean, Aberegg, Scott, Risk, Ilene, Willardson, Sarah, Carter, Amy, Nakashima, Allyn, Duncan, Janae, Burnett, Cindy, Atkinson-Dunn, Robyn, Dunn, Angela
- Database ID:
- RTHC-02135
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
What caused EVALI?
Evidence from this and other investigations linked the lung injuries primarily to vitamin E acetate, a thickening agent added to illicit THC cartridges.
Were legal THC products involved?
Most THC products were acquired from informal sources like friends or illicit dealers, not from licensed dispensaries.
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Cite This Study
https://rethinkthc.com/research/RTHC-02135APA
Lewis, Nathaniel; McCaffrey, Keegan; Sage, Kylie; Cheng, Chia-Jung; Green, Jordan; Goldstein, Leah; Campbell, Hillary; Ferrell, Deanna; Malan, Nathan; LaCross, Nathan; Maldonado, Alejandra; Board, Amy; Hanchey, Arianna; Harris, Dixie; Callahan, Sean; Aberegg, Scott; Risk, Ilene; Willardson, Sarah; Carter, Amy; Nakashima, Allyn; Duncan, Janae; Burnett, Cindy; Atkinson-Dunn, Robyn; Dunn, Angela. (2019). E-cigarette Use, or Vaping, Practices and Characteristics Among Persons with Associated Lung Injury - Utah, April-October 2019.. MMWR. Morbidity and mortality weekly report, 68(42), 953-956. https://doi.org/10.15585/mmwr.mm6842e1
MLA
Lewis, Nathaniel, et al. "E-cigarette Use, or Vaping, Practices and Characteristics Among Persons with Associated Lung Injury - Utah, April-October 2019.." MMWR. Morbidity and mortality weekly report, 2019. https://doi.org/10.15585/mmwr.mm6842e1
RethinkTHC
RethinkTHC Research Database. "E-cigarette Use, or Vaping, Practices and Characteristics Am..." RTHC-02135. Retrieved from https://rethinkthc.com/research/lewis-2019-ecigarette-use-or-vaping
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.