State medical officials are taking steps to make sure clinicians across North Carolina are aware of a dangerous trend.
"This is a big concern," said North Carolina Department of Health and Human Services State Epidemiologist Dr. Zach Moore.
Three vape users recently landed in the hospital and we're being told for some folks, these weren't just in-and-out visits.
"(The patients were) needing to be in the intensive care unit on ventilator support," said Dr. Moore. "These have been pretty severe outcomes."
RELATED: North Carolina Department of Health investigating 3 reports of severe lung disease after vaping
All of the North Carolina smokers reported using e-cigarettes or vaping devices weeks before becoming sick.
DHHS is investigating the cases and officials are trying to figure out what products and devices were used before the patients became sick.
The items can contain harmful substances such as heavy metal and ultra-fine particles, DHHS said.
There have been similar incidents in other states, including Wisconsin, Illinois, California and Minnesota, and the CDC is reviewing the cases as well.
RELATED: 11 teens hospitalized with lung damage linked to vaping
Officials said the symptoms were similar to pneumonia or viral infections.
The smokers had shortness of breath, fever, cough, nausea or vomiting.
"We've seen huge increases in the number of people vaping," said Dr. Moore.
The cases come as adolescent use sharply rises.
A recent DHHS study found e-cigarette use by high school students shot up nearly 900 percent in 2017 and rose 400 percent among middle school students.
"We are very focused on this investigation, but we are concerned about the bigger picture of kids starting to vape and kids getting exposed to nicotine, being exposed to other harmful substances," said Dr. Moore.
DHHS urges people to learn more about e-cigarettes and vaping products here.
For help quitting, people are encouraged to call I-800-QuitNow (1-800-784-8669) or visit this website.
NC health officials say 3 vaping hospitalizations are a 'big concern'