Nine people with a history of vaping have been admitted to New Jersey hospitals this month with “severe lung illness,” the state Health Department announced Friday.

New Jersey joins six other states where more than 50 cases of lung disease have been reported and linked to electronic cigarettes and other vaping devices.

The patients in New Jersey, primarily between the ages of 17 and 35, suffered from cough, shortness of breath and fatigue before they got worse and were admitted to a hospital, acting Health Commissioner Judith Persichilli’s announced said.

The state asked local health officials and medical professionals to look out for patients with respiratory symptoms with “no known infectious cause,” and who report a history of using vaping products.

E-cigarettes have been perceived as a less toxic alternatives to cigarettes and a way for adults to quit smoking. But teens and young adults are increasingly attracted to the vapor-generating devices with their fruity or other flavors and high nicotine content.

E-cigarette use rose 78 percent among high school students and 48 percent among middle school students from 2017 to 2018, according to the U.S. Food and Drug Administration. A 2018 National Academy of Medicine report found evidence that youth who used e-cigarettes were more likely to take up tobacco products, according to the U.S. Centers for Disease Control and Prevention.

In a statement Monday, New Jersey Vapor Rights Coalition President Danish Iqbal said that the lung illnesses reported in states across the country are likely caused by consuming THC products and sold on the black market.

“It is negligent for the media, health professionals, and other organizations to cast aspersions on the vaping industry, which is responsible for not only helping so many cigarette smokers quit their harmful habit, but ensuring there are distribution and marketing standards surrounding the sale of e-liquid to guarantee safe and responsible use,” Iqbal’s statement said.

The Associated Press contributed to this report.