From the Guidelines
No, THC is not the only risk factor for developing E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI). While vitamin E acetate, an additive found primarily in THC-containing vaping products, has been strongly linked to EVALI cases, other factors also contribute to risk, as reported in a 2021 study published in JAMA 1. Non-THC vaping products, particularly those containing nicotine, have been implicated in some EVALI cases. Additional risk factors include:
- Using products from informal sources like friends, family, or unlicensed dealers
- Using counterfeit or modified devices
- Mixing substances or modifying e-liquids
- The frequency and intensity of vaping may also influence risk Individual factors such as underlying lung conditions or immune system vulnerabilities likely play a role in determining who develops EVALI when exposed to harmful vaping substances. For safety, users should avoid all THC-containing vaping products, particularly those from informal sources, and consider the potential risks of all vaping products, as the long-term effects remain incompletely understood, as noted in the 2021 JAMA study 1.
From the Research
Risk Factors for EVALI
- The use of tetrahydrocannabinol (THC)-containing products is a significant risk factor for developing E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI) 2, 3, 4.
- Vitamin E acetate, often found in THC-containing products, is also a potential cause of EVALI 3, 4, 5.
- Obtaining products from informal sources, such as friends or unlicensed retailers, increases the risk of EVALI 2, 4.
Other Potential Risk Factors
- Nicotine-containing products may also contribute to the development of EVALI, although the evidence is less clear 2, 4.
- The use of cannabidiol (CBD)-containing products has been reported in some EVALI cases, but its role as a risk factor is uncertain 4.
- Other substances, such as those found in counterfeit products, may also play a role in the development of EVALI 2.
Diagnosis and Treatment
- EVALI is typically diagnosed through a process of eliminating other possible conditions, as there are no specific biomarkers for the disease 6.
- Treatment for EVALI usually involves supportive respiratory care and ruling out infectious causes, with corticosteroids potentially being beneficial in some cases 3.
- Patients with EVALI may require hospitalization, especially if they are hypoxic or have comorbidities 3, 4.