Photograph: Amer Ghazzal/REX/Shutterstock

Paul Aveyard, a professor of behavioural medicine at the University of Oxford, said:

“These cases are worrying and need investigating but advice from all official bodies in the UK is that it is always preferable to vape than to smoke. These reports should not change that advice.”

The outbreak has led to fears that vapers in the UK could also be affected. However, Martin Dockrell, head of Tobacco Control at Public Health England, drew a distinction between vaping in the US and the UK. He said reports suggested that most cases in the US had been linked to people using illicit vaping fluid, bought on the streets or homemade, some containing cannabis products, like THC, or synthetic cannabinoids, like spice.

“Unlike the US, all e-cigarette products in the UK are tightly regulated for quality and safety by the Medicines and Healthcare Products Regulatory Agency and they operate the yellow card scheme, encouraging vapers to report any bad experiences,” he said.

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