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NC Department of Health and Human Services
NC DPH: Chronic Disease and Injury Section
N.C. Public Health Home

Tobacco Prevention and Control Branch


Final Update, 02/20/2020

Severe Lung Disease among People Who Reported Vaping [more]

The North Carolina Department of Health and Human Services (NC DHHS) is investigating cases of severe lung disease among people who all reported recent vaping or dabbing (vaping products include nicotine, marijuana oils, extracts, or concentrates). NC DHHS is collaborating with the Centers for Disease Control and Prevention (CDC) and other state health departments as part of a national investigation.

As of 02/20/2020, 78 cases have been reported in individuals in North Carolina ranging in age from 13 to 72 years. (Note: 2/20/20 is the final website update for this investigation.)

  • 02/20/2020: Additional details on cases in North Carolina (PDF, 324 KB)
  • Patients experienced severe respiratory symptoms including cough and shortness of breath. Patients also reported experiencing fever, fatigue, chest pain, nausea, vomiting, and diarrhea.
  • Most cases have been hospitalized and have required respiratory support. No deaths have been reported.

Additional Outbreak Information

Nicotine found in e-liquids is highly addictive. For help quitting, please call 1-800-QuitNow (1-800-784-8669) or visit QuitlineNC.

Growing Number of North Carolina Teens at Risk of Addiction to Nicotine, Study Finds

Infographic for Teachers and Parents: Is that a USB Stick or an E-cigarette (Juul)? (PDF, 1.2 MB, JPG, 1 MB)

Electronic Cigarettes / E-Cigarettes

Epidemic Among Young People


  • No electronic cigarettes have been approved by the FDA as safe and effective aids for quitting tobacco.
  • QuitlineNC - North Carolina’s tobacco cessation service can help anyone quit any tobacco product, including e-cigarettes.
  •, including the smokefreeTXT program
  • This is Quitting, a Text-to-quit program from the Truth Initiative

Secondhand Aerosol

Fires and Explosions

Hazardous Waste


E-cigarettes are a class of tobacco products which are battery-powered devices that provide doses of nicotine and other additives to the user in an aerosol, often referred to as vapor. There are many types of these products available in the United States, including e-cigarettes, e-hookahs, hookah pens, vape pens, mods, e-cigars and others. Some are disposable, single-use varieties, while others can be refilled and/or recharged for repeated use. The most recent generation uses pre-filled pods that can be snapped into the device.

Nicotine is highly addictive, and poses health risks, particularly for young people. Pregnant women can transfer nicotine to their developing fetus; nicotine is toxic to the developing baby. Evidence also suggests that nicotine exposure during adolescence may have harm brain development of young people, potentially up to age 25.

The U.S. Food and Drug Administration (FDA) has the authority to regulate the marketing, sale and manufacture of e-cigarettes (and other tobacco products). In January 2020 the FDA issued a new rule banning the sale of e-cigarette nicotine cartridges or pods that come in flavors besides tobacco and menthol beginning Feb 1, 2020. To follow other federal actions, visit the FDA website.

While new studies continue to come in about e-cigarettes, questions remain about their safety. Some studies have shown potentially harmful ingredients and other concerns. So far, studies on the safety and health impact of these products and their use as a tobacco cessation aid, have had mixed results.

The use of e-cigarettes by North Carolina high school students increased 894 percent from 2011 to 2017, and similar patterns are seen nationally and in other states. There is also concern that secondhand exposure to the secondhand aerosol (vapor) from electronic cigarettes may pose a health hazard to others (PDF, 272 KB).

Regulating the Sale of E-Liquid Containers

Effective December 1, 2015, NC law prohibits the sale of e-liquid containers without child-resistant packaging and requires a label for any e-liquid container that contains nicotine. The law creates a new Class A1 misdemeanor for a violation. Also, any person, firm, or corporation that violates the provisions of this law shall be liable in damages to any person injured as a result of the violation. See a copy of the law.