Most people assume JUULing and vaping is less dangerous than smoking cigarettes, but a new study finds that people who had ever vaped are 21% more likely to develop a respiratory disease, and those currently vaping are at 43% increased risk.

“This provides some of the very first longitudinal evidence on the harms associated with e-cigarette products,” says corresponding author Dr. Andrew Stokes, assistant professor of global health at Boston University of Public Health. The study was conducted along with researchers from Boston University School of Medicine and published in JAMA Network Open.

“In recent years we have seen dramatic increase in e-cigarette use among youth and young adults, which threatens to reverse decades of hard-fought gains,” he tells JAMA. “This new evidence also suggests that we may see an increase in respiratory disease as youth and young adults age into midlife, including asthma, COPD, and other respiratory conditions.”

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