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Raleigh, N.C. — Some may consider vaping safer than smoking traditional cigarettes, but new research from the UNC School of Medicine suggests that using e-cigarettes long-term may lead to a higher risk of emphysema.

In the study, lung fluids were sampled from 41 people — smokers, vapers and non-smokers. Researchers found that vapers, like smokers, had higher levels of protease enzymes — a trait that tends to cause emphysema.

“If they keep using these products for about 20 years, it is likely that they will get emphysema,” Robert Tarran, the professor who led the study, told The News & Observer.

Emphysema is a lung condition that causes a shortness of breath as a result of damage to the lung tissue, according to the American Lung Association.

The study, published this month, comes as the number of people hospitalized with lung-related illnesses possibly connected to vaping continues to rise. According to the Centers for Disease Control and Prevention, 153 possible cases of severe lung illness associated with e-cigarettes were reported from June 28 to Aug. 20 around the country.

E-cigarettes come in many forms, but they all heat chemical “e-liquids” in detachable cartridges that contain nicotine and flavors so users can inhale vapors. Because of the health risks associated with cigarettes, e-cigarettes have emerged as an alternative nicotine consumption.

Tarran specializes in e-cigarette research and is a member of the Marisco Lung Institute at the UNC School of Medicine. He plans to continue his research and conduct studies on a wider group of about 100 people.

Other studies have shown vaping to be harmful. But many of the e-cigarette liquids that are researched may no longer be on the market by the time the results are available.

“It is such a fast field, and it takes a long time to study, so by the time we have our results, people may be consuming new e-liquids,” Tarran said.

E-liquids have varying but consistently high amounts of tobacco and varying “toxicity” as a result of different combinations of chemicals, according to a database of e-liquids.

Consumers may find it difficult to identify the source of e-liquids. For example, Amazon sells empty packaging for brand names like Dank Vapes, Cali Plug and Dabwoods, which could lead consumers to believe they are buying a legitimate product when it has been modified.

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