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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)

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However, they have also raised concerns, especially among health professionals and policymakers, due to potential health risks associated with vaping, such as lung problems and nicotine addiction, as well as concerns about the appeal of these products to young people