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Researchers are also examining other substances in vaping products, such as flavoring agents, heavy metals, and other chemicals, to determine if they contribute to the development of EVALI

The clinical trials on which Professor West and colleagues based their guidelines involved more intensive behavioural support provided by specialists trained and employed for the purpose

One theory is that chemicals in certain e-cigarette products, such as THC the chemical in marijuana are to blame for the outbreak in illness

"However, the impact is asymmetrical: the tendency for adolescents to follow their friends into smoking is stronger." Haas, who worked with David Schaefer, associate professor of human evolution and social change, Arizona State University, said that the addictive effect of nicotine may be the strongest influence on an adolescent's inability to help their friends quit smoking

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