Last Friday, the U.S. Food and Drug Administration (FDA) issued a statement regarding investigations by the agency and other state and federal officials into “distressing incidents” of severe respiratory disease linked to using e-cigarette products. One person has died and the agency had received 215 reports of possible cases of respiratory disease linked to e-cigarettes as of August 27.

The U.S. Centers for Disease Control and Prevention (CDC) and the FDA are working to develop an overall picture of the incidents and of the products or substances used, including “investigating the brand and types of e-cigarette products, whether any of them are products that would fall within the FDA’s regulatory authority, as well as where they were obtained.”

The FDA is also analyzing samples provided by state officials to determine whether the samples contain nicotine, substances such as THC (the psychoactive ingredient in marijuana) or other cannabinoids, or other chemicals.

In its statement, the FDA said about possible causes of the incidents:

At this time, there does not appear to be one product involved in all of the cases, although THC and cannabinoids use has been reported in many cases. At this time, the specific substances within the e-cigarette products that cause illness are not known and could involve a variety of substances.

In a Health Alert Network (HAN) statement on disease and the use of e-cigarettes, the CDC warned:

E-cigarettes containing nicotine have the potential to help some individual adult smokers reduce their use of and transition away from cigarettes. However, e-cigarettes are not currently approved by the Food and Drug Administration (FDA) as a quit smoking aid, and the available science is inconclusive on whether e-cigarettes are effective for quitting smoking.

According to the CDC, no single substance or e-cigarette product has been, to date, consistently associated with illness. The agency makes six recommendations for members of the public:

• While this investigation is ongoing, if you are concerned about these specific health risks, consider refraining from using e-cigarette products.
• Regardless of the ongoing investigation, anyone who uses e-cigarette products should not buy these products off the street (e.g., e-cigarette products with THC, other cannabinoids) and should not modify e-cigarette products or add any substances to these products that are not intended by the manufacturer.
• Regardless of the ongoing investigation, e-cigarette products should not be used by youth, young adults, pregnant women, as well as adults who do not currently use tobacco products. If you use e-cigarette products, monitor yourself for symptoms (e.g., cough, shortness of breath, chest pain) and promptly seek medical attention if you have concerns about your health.
• Adult smokers who are attempting to quit should use evidence-based treatments, including counseling and FDA-approved medications. If you who need help quitting tobacco products, including e-cigarettes, contact your doctor.
• If you are concerned about harmful effects from e-cigarette products, call your local poison control center at: 1-800-222-1222.
• We encourage the public to submit detailed reports of any unexpected tobacco or e-cigarette-related health or product issues to the FDA via the online Safety Reporting Portal.

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