For much of their existence, e-cigarettes &mdash; or &ldquo;vapes&rdquo; &mdash; have been considered by some the &ldquo;safe&rdquo; alternative to smoking cigarettes. Over the last several years, the number of people using these e-cigarettes has skyrocketed, especially among school-aged users. Unfortunately, the debate of whether e-cigs are safer than cigarettes gets confused with the debate that e-cigs are safe. Today, we do not know how much safer e-cigs may be than smoking, and we have rising concerns about serious illnesses that may occur from e-cigs that are different from smoking-related illness. Additionally, we have serious concerns regarding the addictiveness of newer products that deliver very high nicotine levels. Nationwide vaping use carries a three-pronged problem: the addictiveness among youth, claims that e-cigs help some people quit and what we do not know about unique effects that e-cigs may have different from smoking. As deputy director and a thoracic medical oncologist at The Ohio State University Comprehensive Cancer Center &ndash; Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC &ndash; James), I&rsquo;ve worked closely with other members of the medical community to better understand the health effects of e-cig usage. In recent years, there has been some debate over the safety of e-cigarettes, but the picture has grown clearer. The Food and Drug Administration declared youth e-cigarette use an &ldquo;epidemic.&rdquo;&nbsp;The American Cancer Society &ldquo;strongly urges&rdquo; against the use of e-cigarettes. For smokers who have quit with e-cigs, they should transition to quitting all inhaled nicotine products. For people who are concerned about resuming smoking if they discontinue e-cigs, they should use known effective methods for smoking cessation (for example nicotine patches, gum or lozenges). There are prescription methods that can help smokers quit. The Center for Disease Control had to coin the term EVALI&nbsp;&mdash; short for &ldquo;e-cigarette or vaping product use-associated lung injury&rdquo; &mdash; to classify the hundreds of people with vaping-related lung illnesses. Whether or not EVALI is caused by e-cigs is unclear but highlights the fact that we do not know the effects of inhaling aerosolized e-cig liquids. Across the United States, we&rsquo;ve now seen more than 1,600 EVALI cases result in more than 30 deaths. EVALI is believed to be &ldquo;disproportionately affecting young people&rdquo; and represents yet another reason for concern over the global e-cigarette epidemic. With all this information in mind, it&rsquo;s more important than ever that initiatives like the American Cancer Society&rsquo;s Great American Smokeout on Nov. 21 include e-cigarette usage in their messaging. This nationwide event should represent an opportunity for parents to seize the moment and discuss with their children the dangers of e-cig use. Thanks to their enticing flavors and colorful, inconspicuous packaging, e-cig use is rising dramatically in younger populations. As a parent, it&rsquo;s important to recognize that children should be avoiding these substances entirely. It is now believed that e-cigs can be even more addictive than traditional tobacco use, and by including e-cigs as part of the Great American Smokeout, we can help ensure that young populations avoid a lifelong addiction. The risk associated with these products highlights the fact that we are long overdue for a nationwide health plan that drastically impacts the use and sale of e-cigarettes among our younger generation. It is crucial that we develop a comprehensive plan that addresses the addictive nature of this habit, sends a message and decreases the number of future smokers. We need actionable steps that work to prevent our youth from engaging in addictive behaviors that are marketed as &ldquo;safe&rdquo; nicotine alternatives. Inclusion in the Great American Smokeout would mean a commitment to protecting our youth from these potential risks, but it&rsquo;s just the beginning. As EVALI deaths increase and the number of young e-cig users continues to climb, the need for action grows more dire. At the OSUCCC &ndash;&nbsp;James, our ongoing research on vaping and its side effects will continue to shed important light on the topic. But we can&rsquo;t combat this epidemic alone. We need a comprehensive, nationwide plan that addresses the addictive nature of this habit, its harmful side effects and the ease with which children have access to e-cigarettes. Dr. Peter Shields is deputy director and thoracic medical oncologist at The Ohio State University Comprehensive Cancer Center &ndash; Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. He specializes in lung cancer treatment and prevention research, and is working to develop more rational prevention methods and improve early detection of cancer.