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Many questions remain about all of the potential causes of EVALI, but the CDC has concluded that vitamin E acetatean additive that has been sometimes used to dilute black-market THC vaping cartridgesis strongly linked to the EVALI outbreak. This conclusion is based on evidence from several laboratory studies conducted by CDC researchers identifying vitamin E acetate in the lungs of EVALI patients, including in all 29 patients analyzed in a November 2019 study and 48 of 51 patients analyzed in a December 2019 study (but none of the 99 healthy participants in a comparison group)

The effects of nicotine on critical components of reward pathways and circuits involved in learning, memory, and mood are likely to contribute to increased addiction and long-term behavioral problems in adolescents

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