The illnesses have rocked the cannabis and nicotine-vaping industries. On Sept. 24, Governor Charlie Baker banned the sale of both types of vaping devices and products for four months, the toughest measure in the country. Other states, such as Rhode Island, have banned flavored electronic cigarettes.
The Hampshire County woman was among the 121 suspected cases reported to Massachusetts health officials since Sept. 11. That’s when the state started requiring clinicians to notify the Department of Public Health about patients who vaped and had otherwise unexplained lung abnormalities and worsening symptoms such as trouble breathing, fatigue, chest pain, coughing, or weight loss.
So far, Massachusetts has determined 19 cases in which lung injuries are confirmed to be or are probably part of the nationwide outbreak of vaping-related lung illnesses.
“Today I was deeply saddened to hear about the death of a patient who had this illness,” Dr. Monica Bharel, Massachusetts’ public health commissioner, said in a statement. “We are investigating these cases as quickly as possible and working with our federal partners to better understand this outbreak.”
Federal officials have said that most of the illnesses nationwide seem linked to concentrated marijuana oil vape products, largely those purchased from unlicensed sellers.
However, 17 percent of affected patients interviewed nationwide reported vaping only nicotine. And no single product or chemical has been linked to all cases.
The investigation has been complicated by the fact that many patients were reluctant to say they vaped an illegal drug, or one obtained illicitly, according to the US Centers for Disease Control and Prevention.
In a statement, a spokesman for the governor said Baker was “saddened to learn that a life has been lost to a vaping-related illness.” Baker pledged to continue to work with state and federal health authorities “to collect more information about what is making people sick.”
Dr. Michael Siegel, a Boston University professor of community health, said that Massachusetts will have a better chance of helping consumers avoid dangerous products if it releases more information about what’s causing the illnesses.
“The message that’s being sent is not very clear” because of the ban on all vaping products, Siegel said.
“The message should be: ‘We may not have all the answers but we do know that black-market THC cartridges seem to be at least one of the major drivers of this.’ ”
Baker’s office has pointed to some patients’ illnesses nationwide as being possibly linked to licensed cannabis dispensaries or nicotine vape products.
Massachusetts health officials last week released details for 10 of the 19 patients whose cases are at least probably linked to vaping. They were mostly female. Five were under age 20, three were 40 to 49, and two were 20 to 39.
Of the 10, five reported vaping only cannabis oils, four reported vaping both marijuana and nicotine products, and one reported vaping only nicotine.
Officials have not specified where any of the products came from.
Mayo Clinic doctors who analyzed lung tissue samples from sickened vaping patients found that the injuries appeared to be caused by undetermined toxic chemicals that damaged the lung tissue, killed cells in the airway lining and the lungs, and prompted swelling, making breathing even harder.
Dr. Jonathan Winickoff, a pediatrician who studies vaping at Massachusetts General Hospital, said people should avoid vaping all products — nicotine or cannabis-derived — because of the lack of information on the health effects of chemicals used in both types of products.
“I’d like to make sure that we don’t have any further deaths in Massachusetts,” Winickoff said. “The most important thing that the government officials can do is to get the word out about replacing any vaped nicotine products with FDA-approved nicotine.”
The state is also offering free nicotine patches and gum to people who call its help line because they want to quit using tobacco.
Baker’s ban has prompted a backlash by medical marijuana patients and former smokers who say they relied on vaping for health reasons. Some have driven to nearby states, while others have turned to the illicit market or to combustible cigarettes.
Baker has said he focused on input from medical experts, not the industry, for his decision.
Dr. Michael Sinha, a research fellow at Harvard Medical School, said he feared that Baker’s ban was pushing people into the illicit market, where products are more dangerous, and came too soon before it was clear whether legally sold products were part of the problem.
“We generally don’t take these types of public health responses until we have the evidence,” Sinha said. “Sure, it’s fine to imagine in a vacuum if you cut off the supply, people will just stop using, but that’s not what physiological dependence is.”
Material from The New York Times was used in this report. Naomi Martin can be reached at naomi.martin@globe.com. Follow her on Twitter @NaomiMartin.