Vaping is the new trend, but is it really good for you? Studies show otherwise a mystery lung illness linked to vaping is on the rise, and U.S. health officials are warning people to avoid electronic cigarettes until they figure out why some users are developing life-threatening breathing illnesses. The California Department of Public Health is investigating 57 potential cases of acute lung disease among people with a recent history of vaping, beginning in late June. Some cases involve people who vaped cannabis products purchased from unlicensed sources, though the agency has not provided a specific number.

      The disclosure came on the same day U.S. health officials renewed calls for people to stay away from e-cigarettes until the cause of the illnesses is determined. Officials have identified about 450 possible cases, including as many as five deaths, in 33 states.

Most patients report using both nicotine and THC ( the chemical that get users “ high “ ) though some report vaping only nicotine. Dr. Danielle Ramo, a San Francisco clinical psychologist who has researched the impact of vaping as an associate professor of psychiatry at UC San Francisco and the research director at the Hopelab, says while the cases of lung disease remain under investigation it’s clear vaping is likely the cause.

“The exact cause of the lung disease has not been identified, but it is likely due to additives in the vaping liquid including vitamin E that can be dangerous when they are heated and inhaled,” says Ramo. “Not all vaping products have these additives, but it can be hard to know which ones have them and which ones don’t because not all ingredients are listed on vaping liquids, especially black market products. The only way to avoid these particular ingredients is not to vape.”

Ramo has worked with teens fighting vaping addictions. While health officials haven’t released the ages of the lung-disease patients and the prevalence among teenagers is unclear at this point, it’s crucial for parents to have conversations with their children about the risks. Issues that should be discussed include the risk of exposure to some of the same toxins in cigarettes, the risk of long-term nicotine addiction, including moving on to smoking cigarettes, and the potential for these products to cause lung disease or death,” she advises.