The 2019 vaping lung injury outbreak: 805 cases, 12 deaths, most linked to THC products
A multistate outbreak of lung injuries associated with vaping affected 805 patients across 46 states, with 12 confirmed deaths. Of patients with known substance data, 76.9% reported using THC-containing products.
Quick Facts
What This Study Found
As of September 2019, 805 cases of vaping-associated lung injury were reported. Among 514 patients with substance data, 76.9% used THC-containing products, 56.8% used nicotine products, 36.0% used THC exclusively, and 16.0% used nicotine exclusively. The median patient age was 23, and 69% were male.
Key Numbers
805 cases across 46 states. 12 deaths in 10 states. Median age: 23 years. Range: 13-72 years. 69% male. 76.9% used THC products. 36% used THC exclusively.
How They Did This
CDC-coordinated multistate surveillance investigation using case reports from 46 state health departments and one territory as of September 24, 2019.
Why This Research Matters
This was a landmark public health emergency that changed how regulators, clinicians, and consumers think about vaping safety. The strong association with THC products highlighted the risks of unregulated cannabis vaping cartridges.
The Bigger Picture
The EVALI outbreak (later linked primarily to vitamin E acetate in illicit THC cartridges) reshaped the vaping landscape, leading to regulatory changes and heightened consumer awareness about the importance of product sourcing.
What This Study Doesn't Tell Us
Data were collected early in the outbreak (September 2019) and the specific chemical cause had not yet been identified at time of publication. Substance use was self-reported. The investigation was ongoing.
Questions This Raises
- ?What specific additives caused the lung injuries?
- ?Were regulated, legal THC products also implicated?
- ?How do we prevent similar outbreaks as cannabis vaping continues to grow?
Trust & Context
- Key Stat:
- 76.9% of patients used THC-containing vaping products
- Evidence Grade:
- Strong: large-scale CDC-coordinated national surveillance with 805 confirmed cases across 46 states.
- Study Age:
- Published in 2019.
- Original Title:
- Characteristics of a Multistate Outbreak of Lung Injury Associated with E-cigarette Use, or Vaping - United States, 2019.
- Published In:
- MMWR. Morbidity and mortality weekly report, 68(39), 860-864 (2019)
- Authors:
- Perrine, Cria G, Pickens, Cassandra M, Boehmer, Tegan K, King, Brian A, Jones, Christopher M, DeSisto, Carla L, Duca, Lindsey M, Lekiachvili, Akaki, Kenemer, Brandon, Shamout, Mays, Landen, Michael G, Lynfield, Ruth, Ghinai, Isaac, Heinzerling, Amy, Lewis, Nathaniel, Pray, Ian W, Tanz, Lauren J, Patel, Anita, Briss, Peter A
- Database ID:
- RTHC-02226
Evidence Hierarchy
Watches what happens naturally without intervening.
What do these levels mean? →Frequently Asked Questions
What caused the EVALI outbreak?
Subsequent investigation identified vitamin E acetate, used as a cutting agent in illicit THC vaping cartridges, as the primary cause. This was not yet known at the time of this report.
Were legal cannabis vape products involved?
The investigation ultimately found that most cases involved illicit or informally sourced THC cartridges rather than products from licensed dispensaries, though this distinction was still being established at the time.
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Cite This Study
https://rethinkthc.com/research/RTHC-02226APA
Perrine, Cria G; Pickens, Cassandra M; Boehmer, Tegan K; King, Brian A; Jones, Christopher M; DeSisto, Carla L; Duca, Lindsey M; Lekiachvili, Akaki; Kenemer, Brandon; Shamout, Mays; Landen, Michael G; Lynfield, Ruth; Ghinai, Isaac; Heinzerling, Amy; Lewis, Nathaniel; Pray, Ian W; Tanz, Lauren J; Patel, Anita; Briss, Peter A. (2019). Characteristics of a Multistate Outbreak of Lung Injury Associated with E-cigarette Use, or Vaping - United States, 2019.. MMWR. Morbidity and mortality weekly report, 68(39), 860-864. https://doi.org/10.15585/mmwr.mm6839e1
MLA
Perrine, Cria G, et al. "Characteristics of a Multistate Outbreak of Lung Injury Associated with E-cigarette Use, or Vaping - United States, 2019.." MMWR. Morbidity and mortality weekly report, 2019. https://doi.org/10.15585/mmwr.mm6839e1
RethinkTHC
RethinkTHC Research Database. "Characteristics of a Multistate Outbreak of Lung Injury Asso..." RTHC-02226. Retrieved from https://rethinkthc.com/research/perrine-2019-characteristics-of-a-multistate
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.