A 17-year-old Bronx boy whose death was disclosed by New York state officials Tuesday is the first teenager in the United States to die of a vaping-related respiratory illness, according to federal and state data.

The teenager died Friday after being hospitalised twice in September with a vaping-related illness, becoming the state's first fatality from the mysterious lung disease, according to state health officials.

" Parents have to know; young people have to know," governor Andrew Cuomo said in announcing the teenager's death Tuesday. "You are playing with your life when you play with this stuff."

The death brought the total number of vaping-related deaths in the United States to 23, according to the Centre for Disease Control and Prevention (CDC) and state agencies. New Jersey health officials said last week that an adult woman was the first resident of that state to die of a vaping-related illness.

The New York City medical examiner's office was conducting its own inquiry into the death announced by the state, according to a spokeswoman for Mayor Bill de Blasio.

"The city is investigating the case in question but no official determination has been made at this time," the spokeswoman, Avery Cohen, said.

Of the 18 deaths tallied by the CDC as of 1 October - the agency's latest official figures - the youngest victim was 27, officials said. The four besides the one in the Bronx reported to state agencies since then involved adults, officials said.

As of Tuesday, the New York state Department of Health had received 110 reports from doctors about severe pulmonary illness among patients ages 14-69 who had used at least one vaping product before becoming sick, officials said. Around 1,100 cases of vaping-related illness had been reported nationwide.

Patients with vaping-related lung injuries typically show symptoms that resemble flu or pneumonia. No single substance has been shown to cause the illness, but several marijuana products have been identified as possible culprits. It had not been determined by Tuesday what substance was responsible in the Bronx death, a state health official said.

Dr Anne Schuchat, principal deputy director of the CDC, said at a news briefing last week that the outbreak in vaping-related illnesses was "continuing at a brisk pace." She emphasised that the illnesses were serious and life-threatening and called the proportion of patients hospitalised and in intensive care "just terrible."

About 70% of the patients were male, 80% were under 35 and 16% were younger than 18, she said. The median age for those who died was about 50.

Several states, including New York, have responded to the outbreak, and to the increasing rate of teenage vaping, with efforts to ban flavoured e-cigarette pods that are especially popular with children. The Trump administration said last month that it was considering a federal ban on flavoured e-cigarettes.

Last week, a state appeals court blocked the New York ban on the flavoured pods just before it was to take effect. Vaping groups had sued to stop the ban, arguing that it would hurt retailers and adults who use the products to quit smoking tobacco. The vaping industry is also battling a more extensive ban of all vaping products in Massachusetts, which recently reported its first vaping-related death.

The disclosure of the Bronx teenager's vaping-related death came as New York City filed a federal lawsuit against 22 websites it claims targeted and sold e-cigarette products to people under 21, the minimum legal age to buy tobacco and e-cigarette products in New York.

The online retailers named in the suit are based in California, Florida and about a dozen other states. They are accused of luring underage customers in New York by advertising on social media, and by offering products in flavours like "Lemon Twist," "Candy Cane," "Cookie Butter," "Fruity Loops" and "SaltNic Mighty Mint."

The city also said in the suit that the sites targeted minors by selling devices that were "small and inconspicuous, such that they can be easily hidden from parents and educators."

In a statement, Mr de Blasio accused the sites of "preying on minors." In the suit, the city said it wanted the sites to stop selling and marketing in New York City, and to pay the "costs of abating the public health crisis of underage e-cigarette use within the city."

The New York Times

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