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Frequently Asked Questions: Lung Injury Investigation

Q: What is vaping, and how does it involve e-cigarettes?

Vaping is the use of battery-powered devices called e-cigarettes, or “vapes,” that allow users to inhale aerosolized liquid (e-juice) and flavorings, and can be used for nicotine or THC – a chemical extracted from cannabis. E-cigarettes can come in all shapes and sizes. Nearly all e-cigarettes contain nicotine, and no amount of nicotine is safe for youth. Nicotine is highly addictive and can have negative impacts on learning, memory, attention span, as well as increase the risk for addiction to tobacco and other drugs.

According to the U.S. Surgeon General, there is an epidemic of e-cigarette use among youth. Recent surveys have shown 37.7 percent of Minnesota high school students have tried e-cigarettes, and 19 percent of high school students use e-cigarettes on a regular basis. Of particular concern, 34 percent of regular e-cigarette users report having vaped cannabis/THC oil at least once.

Q: What problems have been reported among people who vaped illegal cannabis products?

The Minnesota Department of Health (MDH) is posting investigation updates daily at Vaping-Associated Lung Injuries. Symptoms among the Minnesota cases included shortness of breath, fever, cough, and vomiting and diarrhea. Other symptoms reported by some patients included headache, dizziness and chest pain. Among the Minnesota cases interviewed, all report vaping illegal THC products. Many have vaped other products including nicotine-containing products.

Q: What is MDH doing about these cases?

MDH has been working with federal and local public health, and health care providers to investigate the reports of severe lung injuries. We are sharing information on an ongoing basis as we learn more about the risks and how people can best protect themselves.  

Q: Where are these products being sold?

Most patients reported purchasing the illegal vaping materials from the street or receiving or purchasing it from friends.

Q: What vaping materials are implicated?

Patients have reported using a wide variety of vaping devices and products. For the Minnesota cases, the most common link has been use of illegal THC products.

Q: Where are cases being found?

So far approximately 1,300 cases of severe lung injury have been reported from 49 states, the District of Columbia and one U.S. territory, according to the Centers for Disease Control and Prevention (CDC).

Q: I recently vaped illegal cannabis products and now I'm having difficulty breathing. What should I do?

Seek immediate medical attention and tell your provider about your recent history of vaping. Patients and those experiencing symptoms should avoid further use of e-cigarettes and vaping products.

Q: What about products from Minnesota’s medical cannabis program?

While the available evidence from the investigation connects the lung injuries with use of illegal THC products and not products solely from medical cannabis programs, MDH cannot give complete assurance of safety until investigators determine a specific cause of the lung injuries.

It is important to note that all medical cannabis products sold by Minnesota’s two medical cannabis manufacturers must be compliant with state testing standards to ensure they do not contain contaminants. Also, Minnesota's medical cannabis program has surveyed patients about side effects since the beginning of the program. About 20 percent of patients have reported side effects, typically including dry mouth, drowsiness, fatigue or mental clouding. Very few reported lung issues.

Q: What is your advice to people in the medical cannabis program?

MDH advice to all Minnesotans is to not vape illegal THC products. Also, people should not modify e-cigarette products or add any substances to these products that are not intended by the manufacturer.

Vaping is one of several delivery methods allowed under Minnesota’s medical cannabis program, so patients in the medical cannabis program who have concerns about vaping should talk to their provider or pharmacist at Minnesota’s patient cannabis centers about alternatives that may be right for them.

It’s important to keep in mind that patients in the medical cannabis program are using medical cannabis to treat serious health issues. The decision to stop a medication or switch to another option is one that should be made in consultation with the patient’s doctor or other health care provider.

MDH will continue to monitor this situation closely and will work with the two medical cannabis suppliers to consider any modifications that may be indicated if new information comes to light.

Q: Where can I get more information about vaping?

You can visit the MDH website at Vaping-Associated Lung Injuries or E-cigarettes and Vapes to learn more.