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Case Report and Representative Radiographs: Strengths : First cluster identified within a large catchment zone Retrospective chart review identified treatment, course, disposition, and outcome Interviews with cases determined exact exposures For the first time, provided a strict case definition of VALI, including a comprehensive negative infectious workup Limitations : Under-Reporting: Surveillance studies are limited by under-reporting, particularly as patients may not be routinely asked about vaping exposures

Even when some gases are reduced, carbon monoxide can still be present

The Tobacco Regulation Branch had detected the illegal activity during one of its regular cyber surveillance checks

The best tobacco vapes use a minimal formula just the flavor compounds needed to recreate tobaccos natural earthiness, without synthetic sweeteners masking everything