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E-cigarette, or Vaping, Associated Lung Injury (EVALI)

California Brief Update October 1, 2022


​Total cases



​5/249 (2%)


In August 2019, the California Department of Public Health (CDPH) first received reports of patients hospitalized with EVALI, a severe lung disease in people who use some e-cigarette or vaping products that contain cannabis compounds, nicotine, or both. Since the start of the COVID-19 pandemic in March 2020, local health departments have reported 39 cases of EVALI to CDPH, including one associated death.

The peak of the EVALI outbreak occurred in September 2019, both in California and nationally. Vitamin E acetate was found as an additive in many of the vaping products that patients with EVALI used and in lung fluid samples from these patients. Other factors besides vitamin E acetate could also have contributed to or caused this illness. This and more information on the overall outbreak findings from across the United States and U.S. territories is available on the website of the Centers for Disease Control and Prevention (CDC).




​154 (62%)

95 (38%)





​14-76 years

​25 years


Number of counties reporting cases: 31/58 (53%)


CDPH continues to collect reports of EVALI from healthcare providers who report cases to local health departments. CDPH will periodically update this website with basic information about the reported cases, as that information is available.

For Healthcare and Public Health Practitioners

A detailed analysis of the characteristics of EVALI patients in California and the products they used was published in March 2020 in the medical journal JAMA Internal Medicine.

In June 2020, CDPH published a brief report on the cases of EVALI during the COVID-19 pandemic in the journal Morbidity and Mortality Weekly Report.

CDPH continues to ask clinical providers to report EVALI cases to the local health department of the patient's residence and asks local health departments to report cases to CDPH. Clinical providers and local health departments may consult the May 9, 2020 Health Alert "E-cigarette, or Vaping, Product Use-Associated Lung Injury (EVALI) Cases During California's COVID-19 Response" (PDF) for guidance on diagnosing and reporting EVALI in the context of the COVID-19 pandemic.

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