Health officials in Oregon are investigating the recent death of a person who had severe respiratory illness after vaping. If confirmed, it would be the second such death reported in the country.
An Illinois resident died last month after developing the lung disease linked to using e-cigarettes.
The Oregon Health Authority reports the individual had used a vaping device purchased from a cannabis dispensary before becoming ill. The death occurred in July.
The person had developed similar symptoms to the 330 other people nationwide with confirmed or suspected cases of life-threatening vaping-related lung diseases. Doctors say patients report vaping either nicotine or THC, the high-inducing ingredient of marijuana, and then progressively getting sicker before arriving at the hospital coughing and with trouble breathing and chest pain.
Many also have experienced vomiting, diarrhea, fever, fatigue and weight loss.
"We don’t yet know the exact cause of these illnesses — whether they’re caused by contaminants, ingredients in the liquid or something else, such as the device itself," Dr. Ann Thomas, a public health physician within the Oregon Health Authority, said in a statement.
Also Wednesday, North Dakota announced its first possible vaping-related lung illness, joining more than two dozen other states with cases.
According to an NBC News survey of state health departments, 330 such illnesses are either confirmed or under investigation nationwide — from California to the Midwest and the East Coast.
The Food and Drug Administration does have authority over e-cigarettes that contain nicotine, but not those that contain THC. And thousands of devices and e-liquid flavors currently on the market have never gone through FDA review.
The Centers for Disease Control and Prevention last week warned the public not to purchase e-cigarettes off the street, but some local health officials are taking that message a step further.
"Vaping and e-cigarette products of any kind contain cancer-causing chemicals, heavy metals such as nickel, tin and lead, and chemical flavorings linked to serious lung disease," said a news release from Summit County Public Health.
"The long-term health impacts for using these products are unknown, but the immediate dangers of vaping are becoming increasingly evident and alarming in Ohio and across the nation," it continued.
The Ohio Department of Health is investigating six possible vaping-related respiratory illnesses. Its neighbor to the north, Michigan, is also looking into six cases.
On Wednesday, Michigan Gov. Gretchen Whitmer announced a ban on most flavored e-cigarettes, becoming the first state to do so.
The ban will cover both online and in-store sales of all e-cigarette flavors except tobacco. It will take effect in a few weeks, and allow businesses 30 days to comply.
A study conducted in 2016 and published last year in the Annals of Internal Health found nearly 11 million adults used e-cigarettes. But that is likely a vast underestimate of the true number of people who vape, because the study included only those over 18.
The CDC reported e-cigarette use among high school students soared 78 percent from 2017 to 2018. That report said that overall last year, more than one in four high schoolers and about one in 14 middle schoolers reported using a tobacco product in the previous 30 days — 4.9 million kids in total.