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"From a public health perspective, we have always been concerned about dual-use of both traditional and e-cig products," said study lead author Marisa Bittoni, an oncology researcher at Ohio State University in Columbus. The U.S. Food and Drug Administration and the European Union are grappling with these issues as they decide how to regulate the products. Unfettered access could leave people vulnerable to unknown health hazards, but there is also the chance that greater restrictions might hurt folks who are trying to forgo conventional—and more dangerous—tobacco products.

In our study, there were between-school differences, which appeared larger for girls than boys. In the univariate analyses, most school-level factors either increased or lowered susceptibility. This was especially the case among girls in S-EC and S-SN, and among boys in S-SM. In the multivariate models, most of the school-level associations were weakened.

The vapor produced by e-cigarettes usually contains nicotine, heavy metals, volatile organic compounds, carcinogens (cancer causing chemicals), and in some cases, flavoring linked to serious lung disease. These and other harmful substances present in e-cigarette&nbsp