If you ask me, the Juuling trend has by now been outdated for a while. Yet, somehow, I still see people gladly inhaling the flavoursome smoke from their little pen look-a-like on a daily basis, not knowing exactly what they’re pumping in and out of their lungs. Just a few days ago, a series of severe lung disease cases appeared in the U.S. and were quickly linked to vaping. The headlines are more than alarming, affirming that e-cigarettes are to be blamed for this disease. Yet after researching the matter, it is clear that no one knows anything for sure. So what is this lung disease, and is it really connected to vaping?

According to public health officials in the U.S., hundreds of people have suffered from a severe lung illness, and 5 people died from it over the past three months. In many of these cases, healthy people, sometimes in their teens or early 20s, were affected by the multistate outbreak of pulmonary disease associated with e-cigarette products. Because all of the cases are related to people who confirmed they vape, the federal Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are focusing on trying to figure out which specific part of vaping is dangerous.

Early symptoms of the disease include coughing, fever, nausea, vomiting, and fatigue. A simple cough quickly turns into extreme shortness of breath and leads people to urgent hospitalisation. Public health officials announced that “anyone who has shortness of breath that lasts more than a few hours or becomes severe should seek medical attention quickly.” On lung scans, the illness looks like a bacterial or viral pneumonia that has attacked the lungs, but no infection has been found in testing.

E-cigarettes have now been around for years, though, so why is this outbreak only happening now? News outlets feed readers with two different theories. The first one, presented only by some health officials, is that a dangerous chemical called vitamin E acetate has been added into the pipeline of some vaping products. The second theory is that e-cigarettes have always been this dangerous but that doctors only realised recently where the disease comes from due to vaping’s recent growing popularity. Both theories, however, are still surrounded by uncertainty, with specialists guessing what to them might seem most plausible.

The illness is clearly spreading across the U.S., but could it also be affecting other countries, such as the U.K.? According to figures by the Office for National Statistics (ONS), between 2015 and 2018 the number of people over 16 vaping in the U.K. shot up from 3.7 percent of the population to 6.3 percent. As I previously said, young people are still vaping, Juuling, you name it.  Yet according to Martin Dockrell, head of tobacco control at Public Health England, Brits can all relax. Apparently, a distinction between vaping in the U.S. and the U.K. should be made.

Screen Shot spoke to the co-founder of the association Parents Against Vaping, Dorian Fuhrman, about vaping regulations in the U.S., the association’s work, and how teenagers are the main target customers. “97 percent of kids in the U.S. who vape use flavours, so what we try to do is to support legislation,” Fuhrman told Screen Shot, adding that, “In America, the FDA banned all flavoured cigarettes in 2009 but only left menthol cigarettes on the market, which was a big mistake. So now, there’s no reason for them to allow flavoured e-cigarettes because it’s the same issue, it’s the flavours that attract the kids.” In the U.K., the nicotine levels available in vape liquids are much lower, while in the U.S., as Fuhrman explains, “there’s no limit on the nicotine levels.”

What most people aren’t aware of while reading the recent headlines is that most cases in the U.S. had been linked to people using illegal vaping fluid—some homemade ones, some bought on the black market, some containing THC, or synthetic cannabinoids-like spice. In other words, Americans have been smoking something else than your typical vape pen.

That said, it’s always better to be safe than sorry, and while Martin Dockrell makes a clear distinction between both countries, many vapers in the U.K. also use vaping fluids containing THC. The NHS’ website states that, “In the UK e-cigarettes are tightly regulated for safety and quality,” but that many of the vaping liquids containing THC are imported legally.

Whether the liquids available illegally in the U.K. contain vitamin E acetate or not remains unclear. As for whether e-cigarettes really are the cause of lung disease, well, no one seems to be sure of that either. So, just to be on the safe side, let’s stop vaping, at least until we finally get some accurate information, or least until we forget about the multistate epidemic in the U.S. and carry on with our destructive lifestyles.