Vaping and e-cigarettes have been in the news a lot lately. There&rsquo;s a lot of information and misinformation as well as questions and concerns about long-term consequences for young people. &ldquo;We can&rsquo;t have a generation of our youth, almost 30 percent of them already, addicted to nicotine, using e-cigarettes and potentially going on to cigarettes and other tobacco products that we know cause cancer and heart disease and will literally kill one in three people who use them,&rdquo; says Theodore Wagener, PhD, the director of the Center for Tobacco Research and the co-leader of the Cancer Control Program at The Ohio State University Comprehensive Cancer Center &ndash; James Cancer Hospital and Solove Research Institute. Read on as Wagener sorts through the facts to provide a better understanding of vaping, e-cigarettes and their possible cancer connection. Also, listen as Wagener provides an inside look at vaping research at Ohio State on our Cancer-Free World Podcast. How we got here &ldquo;The first-generation of e-cigs really started to become popular in 2009 and 2010. They were introduced as safe alternatives to &lsquo;regular cigarettes.&rsquo; The manufacturers couldn&rsquo;t call them or market them as a smoking cessation device, as that would have required approval from the Food and Drug Administration. What we found was that most people who used them reduced their &lsquo;regular&rsquo; cigarette consumption for a short time but soon went right back to smoking.&rdquo; The first generation of e-cigs didn&rsquo;t deliver much nicotine &mdash; about 1.5 nanograms in 19 minutes, while cigarettes deliver 15 nanograms in five minutes. The second generation of e-cigs delivered about 8 nanograms in five minutes, and the third generation was up to and a little beyond cigarette levels at 17 nanograms. They were able to accomplish this with more power and more heat. The fourth generation of e-cigs, which is what we&rsquo;re seeing now, have shifted away from all this power. Instead, they use a higher level of nicotine concentration in the liquid. Nicotine is very harsh and burns your mouth. In the early days of e-cigs, the manufacturers didn&rsquo;t know how to make these high levels palatable. Now, they&rsquo;ve learned how to by lowering the pH level. The danger here is that you now have a product that is very palatable and incredibly addictive to first-time users. They&rsquo;re easier to use and more addictive to youth. We&rsquo;ve seen documents from the tobacco industry that show what they look for: products easiest to get kids started on, and that leads to flavored products with lower nicotine levels or making the higher levels of nicotine more palatable. A &ldquo;safe alternative&rdquo; to cigarettes? No e-cig is safe. No one knows the long-term health implications of e-cigs, as that takes 20 or 30 years of research to know. What our initial research indicates is that e-cigs deliver far fewer harmful toxicants than cigarettes, and that&rsquo;s because there&rsquo;s no burning. However, we are seeing some dangerous signs, especially with the e-cigs that have higher wattage and heat, as all this heat is producing more bad chemicals. And with flavored liquids, we&rsquo;re seeing higher levels of formaldehyde, and formaldehyde is a known carcinogen. Flavored liquids are more attractive to teens and younger adults, and we&rsquo;re seeing more and more young people vaping. The difficulty of giving up nicotine Studies show that, with cigarettes, within seven seconds of a puff, the nicotine reaches the brain. It&rsquo;s a stimulant and makes you feel really good. Every year, 70 to 80 percent of smokers say they want to quit &mdash; about half will make an attempt and less than 7 percent will actually be able to quit for six months. The gold standard for cessation is counseling and nicotine replacement therapy such as a patch, lozenge or gum. Combining this with a smoking cessation medication, such as Chantix, has also been effective. The dangers and safety of nicotine are up for debate. I&rsquo;m more of a harm reductionist. I&rsquo;m okay with someone using nicotine as long as it&rsquo;s through a patch, lozenge or gum &ndash; a cleaner method versus a dirtier method. Cigarettes are the dirtiest method. E-cigs can be easier for smokers to switch to, and there are less toxicants when compared to cigarettes. But at the same time, significant numbers of youth are becoming addicted to nicotine. It&rsquo;s up to nearly 30 percent using e-cigs. That&rsquo;s unheard of and so dangerous, and we&rsquo;re going in the wrong direction. Recruitment is ongoing for e-cigarette and tetrahydrocannabinol (THC) vaping studies at the OSUCCC &ndash; James. The study protocol recently expanded to include evaluation of THC and marijuana vapors in qualifying participants ages 18 or older. Numerous mechanisms are in place to maintain confidentiality. For more information about this and other tobacco product studies, visit go.osu.edu/tobacco-research or contact 844-744-2447 or Ecigfirstname.lastname@example.org. To learn more about tobacco-related research studies at Ohio State, visit cph.osu.edu/cats.