The Georgia Department of Public Health has announced the state’s second death from a vaping-linked illness.

No details on the latest death were provided early Wednesday, as the number of people hospitalized continues to climb.

The first person who died in Georgia, announced two weeks ago, was an unidentified man over the age of 35. The agency did not say where he lived, only that he did not live in metro Atlanta.

He had a history of heavy nicotine vaping but no history of vaping THC, which has been linked to a majority of the mysterious vaping-related lung diseases afflicting e-cigarette users.

<p>In this photo made on Friday, Oct. 4, 2019, a woman uses her vaping device in Harmony, Pa. (AP Photo/Keith <span class="wsc-spelling-problem" data-spelling-word="Srakocic" data-wsc-lang="en_US">Srakocic</span>)</p>

Credit: AP Photo/Keith Srakocic

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Credit: AP Photo/Keith Srakocic

The death is one of at least 14 confirmed cases in Georgia. Most patients were hospitalized and developed pneumonia with “no known infectious cause,” according to the agency. They also required respiratory support.

The Centers for Disease Control and Prevention is working with states to investigate more than 1,000 cases of vaping-associated illness. There have been at 18 deaths confirmed in 15 states.

The CDC said most patients who have come down with the vaping illness reported using products containing THC, the main psychoactive chemical in marijuana. About 70% of those sickened are men and most are young; 80% are under 35 years old, according to the CDC. About 16% of the patients are under 18, and 21% of the patients are between the ages of 18 and 20.

No specific e-cigarette device or substance has been linked to all of the cases. E-cigarettes are battery-powered devices that heat liquid, turning it into vapor for inhaling. They are an increasingly popular alternative to combustible cigarettes.

Doctors are reporting cases of otherwise healthy patients, many in their late teens and 20s, showing up in emergency rooms gasping for breath and vomiting. The CDC said the outbreak does not seem to be caused by an infection but by chemical exposure, possibly a solvent mixed with nicotine or THC. Investigators are increasingly focused on thickeners and additives found in illegal THC cartridges sold on the black market.

But with the cause of illness still unknown, the CDC is urging people to consider refraining from using e-cigarettes. People who decide to continue vaping should not buy vaping products off the street, and they should not modify or add any substances to the products.

Symptoms of vaping-associated illnesses, which worsen over time, include cough, shortness of breath, fatigue, chest pain, nausea, vomiting and diarrhea.

The rash of cases has heightened scrutiny of e-cigarettes, even though many health experts consider them less harmful than traditional cigarettes, which release toxins through combustion.

Students and parents arrive for a educational presentation about vaping and the law at Lakeside High School in Atlanta in September. Curtis Compton/ccompton@ajc.com

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Experts who study tobacco policy fear this public health crisis tied to vaping may have unintended consequences, including driving people who vape back to cigarette smoking, which remains the country’s leading preventable cause of death.

Dr. Michael Eriksen, dean of Georgia State University’s School of Public Health, said the epidemic of youth vaping, potential bans on flavors, and the lung disease outbreak have created a perfect storm of confusion around e-cigarettes and their potential to help smokers quit the deadliest of habits.

“This is undermining what we know about vaping and we lose sight of smokers and what this is all about,” he said. “It is not helpful what is going on and it has confused everyone.”

He said it’s important the public realize risky, “illicit marijuana use” is most likely to blame for the outbreak.

Eriksen said public officials and government agencies should take a systematic approach to both e-cigarettes and traditional cigarettes. For example, if policies ban flavors for vaping products, they should also prohibit flavors in traditional tobacco products. If not, ex-smokers could return to smoking deadlier menthol cigarettes or flavored cigars which come in a variety of flavors including chocolate.

Scott Gottlieb, who stepped down as commissioner of the Food and Drug Administration in April, outlined an ambitious anti-smoking plan which included lowering nicotine in traditional cigarettes two years ago. But the agency has yet to unveil its proposal for cutting nicotine.

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