How the medical history of teen EVALI patients differs


An investigation looks at how the medical history of adolescent e-cigarette, or vaping, product use–associated lung injury (EVALI) differs from young adult and adult EVALI cases.

Before the COVID-19 crisis began, one of the biggest public health issues was the proliferation of e-cigarette, or vaping, product use–associated lung injury (EVALI). A recent report in JAMA Pediatrics looked at how adolescent patients with EVALI differed from adult patients with EVALI.

Investigators used the surveillance data that had been reported to the Centers for Disease Control and Prevention during the 2019 outbreak of EVALI. There were of 2155 total cases, which included 360 adolescents who were either hospitalized or deceased. There were 859 young adult cases and 936 adult cases.

The adolescents reported using any tetrahydrocannabinol (THC)-containing (81.7%) and nicotine-containing (62.4%) products, and both (50.8%) types of e-cigarette or vaping products. Adolescents were more likely to report getting their nicotine-containing and THC-containing e-cigarette or vaping products than young adults, particularly for nicotine-containing products. Behavioral, mental, or emotional disorders were common. A history of attention-deficit/hyperactivity disorder was found to be nearly 4 times more likely among teenagers than adults. Similarly, a history of asthma was reported by more adolescents than adults. Gastrointestinal and constitutional symptoms also were found to be slightly more common in teenagers as well.

The COVID-19 crisis has put the EVALI outbreak on the back burner in many ways. The report’s investigators urge clinicians and public health officials to continue discussing EVALI and the link to THC-containing e-cigarette or vaping product use. A thorough and confidential substance use history to discover e-cigarette or vaping use is recommended.



1.    Adkins SH, Anderson KN, Goodman AB, et al; Lung Injury Clinical Task Force and the Lung Injury Epidemiology/Surveillance Task Force. Demographics, substance use behaviors, and clinical characteristics of adolescents with e-cigarette, or vaping, product use–associated lung injury (EVALI) in the United States in 2019. JAMA Pediatr. May 18, 2020. Epub ahead of print. doi: 10.1001/jamapediatrics.2020.0756

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