Sudden, serious lung illnesses that have struck people who used vaping devices have been tied in many cases to products that contain THC, the main active ingredient in marijuana, the U.S. Centers for Disease Control and Prevention said.

Health authorities have identified hundreds of cases of lung disease in people who used vaping products and have been racing to track down the cause. The CDC said in a statement that many of the people had used products containing THC, while others had used a combination of nicotine and THC. A smaller group reported using only nicotine products.

Health officials haven’t reached a final conclusions about the cause of the lung illnesses, which the CDC said was likely associated with some type of chemical exposure. But the agency said that people should consider not using e-cigarettes while they investigate, and watch for any symptoms of lung illness. They also warned against using any modified products or ones bought on the black market.

State health authorities in New York on Thursday said it may have been related to vitamin E acetate.

“We are committed to finding out what is making people sick,” said CDC Director Robert Redfield. “All available information is being carefully analyzed, and these initial findings are helping us narrow the focus of our investigation and get us closer to the answers needed to save lives.”

Three deaths have been reported, one each in Oregon, Illinois and Indiana. The death in Indiana was reported Friday. The state is investigating 30 cases of lung illnesses, eight of which have been confirmed, according to the Indiana State Department of Health.

A preliminary report of 53 patients with the lung illnesses in Illinois and Wisconsin found that 84% had used a product containing THC. The report was published in the New England Journal of Medicine on Friday.

The rapid emergence of the mysterious lung illnesses has raised some concerns about the still-developing e-cigarette and legal marijuana industries. Investors have poured billions of dollars into numerous companies in both sectors, including the richly valued e-cigarette maker Juul Labs Inc., which has been criticized for its marketing practices.

Growing Business

Marijuana vaping products have become increasingly popular in recent years as a discreet way to take a quick puff of pot. The legal cannabis industry sees vaping as a way to draw in consumers beyond the experienced stoners who buy the bulk of traditional marijuana. In addition to being sold in the states that have legalized marijuana, THC vapes have become widely available on the black market.

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