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Because vaping and hookah devices are used differently than traditional cigarettes, we need to consider diseases of both the nose and lungs to evaluate their safety before judging whether one is more risky than another, says study senior author Terry Gordon, PhD, a professor in the Department of Medicine

The survey found 9 percent of 8 th graders, 16 percent of 10 th graders and 17 percent of 12 th graders used e-cigarettes

However, the observed associations between vaping and subsequent cigarette smoking do not necessarily indicate a causal "gateway effect", as shared social, behavioral, or genetic risk factors may contribute to both behaviors

These devices are usually used by experienced vapers, some of whom participate in competitions involving blowing smoke into various shapes and sizes