Hawaii officials are calling on local health care providers to report any cases of patients with lung injuries after vaping. The advisory coincides with national reports of a breathing ailment linked to the vaping devices, including one death in Illinois possibly caused by e-cigarette use.

Officials with the Centers for Disease Control and Prevention said they are looking at 215 possible cases of vaping ailments across 25 states. KHON-TV reported Hawaii is not among the states, but that local health officials want to hear of any lung-related injuries tied to vaping. In a statement, the state Department of Health told the station:

To date, DOH has not received reports of lung injury associated with vaping in Hawaii. With the national concern because of reports in other states, DOH has alerted health care providers and emergency workers to ask patients with lung injuries if they have vaped and report any associated injuries to DOH.

National health officials are recommending people who vape consider avoiding e-cigarettes while they investigate more cases of the breathing ailment linked to the devices.

The warning has special meaning in Hawaii where health and school officials have been alarmed by the higher than average use of e-cigarettes among young people in the state.

While the cause of the ailment remains unclear, officials said Friday that many reports involve e-cigarette products that contain THC, the mind-altering substance in marijuana.

All of the cases under review by the CDC involve teens or adults who have used e-cigarettes or other vaping devices. Symptoms of the disease include coughing, shortness of breath, chest pain, fatigue, nausea and vomiting.

The CDC and Food and Drug Administration warned the public not to buy vaping products off the street. And officials recommended people concerned about the health risks "consider refraining from using e-cigarette products."

Health and Human Services Secretary Alex Azar said in a statement the government is "using every tool we have to get to the bottom of this deeply concerning outbreak."

E-cigarettes generally heat a flavored nicotine solution into an inhalable aerosol. The products have been used in the U.S. for more than a decade and are generally considered safer than traditional cigarettes because they don't create all the cancer-causing byproducts of burning tobacco.

But some vaping products have been found to contain other potentially harmful substances, including flavoring chemicals and oils used for vaping marijuana, experts say.

The mysterious illness underscores the complicated nature of the vaping market, which includes both government-regulated nicotine products and THC-based vape pens, which are considered illegal under federal law.

Eleven states and the District of Columbia allow marijuana for recreational use. THC-based products in these regulated markets are generally inspected for quality and safety, but there is a largely unregulated gray market.

On Thursday, top health officials in the Trump administration reiterated warnings against marijuana use by adolescents and pregnant women, emphasizing the increasing potency of the drug.

The U.S. Centers for Disease Control and Prevention ranks Hawaii number two among states for children grades 6 to 12 who are vaping. Hawaii's e-cigarette usage by its youngsters is double the average for the country as a whole.

According to the state the Health Department, the high rate of use stems mainly from heavy vaping among children and teens in Kauai, Maui and Hawaii counties.

State lawmakers tried to impose more regulations on the $2.5 billion e-cigarette industry as it targets youngsters. But few of the proposals aimed at protecting the health of younger students have become law.

In July, Gov. David Ige vetoed Senate Bill 1405 that would have allowed public school teachers or educators to confiscate e-cigarettes or electronic smoking devices from students. Among other reasons for the veto, the governor said the bill failed to define exactly what qualifies as an electronic cigarette.

Also earlier this year, the state House Finance Committee chaired by Rep. Sylvia Luke killed a proposed local ban on flavored tobacco, noting that teenagers could still buy the products online.