E-cigarette use around the world is booming, especially amongst young people. In 2016 the US Surgeon General identified a 900 percent increase in e-cigarette use in high school students from 2011 to 2015. While e-cigarette vapor certainly doesn't contain the same kinds of carcinogenic compounds as regular cigarette smoke there is a growing body of research to suggest "vaping" may have its own set of unique harmful effects.

A new study from researchers at the University of North Carolina at Chapel Hill has published findings suggesting that e-cigarette use can trigger immune responses in the lung that can contribute to inflammatory lung diseases.

The study examined 44 sputum samples from e-cigarette users, current cigarette smokers, and non-smokers. Amongst the e-cigarette using cohort a significant increase in neutrophil granulocyte- and neutrophil-extracellular-trap (NET)-related proteins was identified. The study notes that while neutrophils are useful in combating pathogens they also are known to contribute to lung diseases such as COPD and cystic fibrosis.

The study also identified similar increases in specific biomarkers associated with lung disease between e-cigarette and cigarette users. An increase in mucin 5AC, a mucus secretion associated with chronic bronchitis and asthma, was also found in both e-cigarette and cigarette users.

It is important to note that this study was small and limited, with the authors including the fact that most of the e-cigarette cohort were formerly cigarette smokers, making it difficult to clearly identify whether these results were solely related to e-cigarette use. The key factor to consider here though is that many previous studies have primarily examined the harm of e-cigarettes in relation to the harmful characteristics of cigarettes, potentially neglecting the unique or novel ways e-cigarettes could be causing harm.

"Comparing the harm of e-cigarettes with cigarettes is a little like comparing apples to oranges," says Dr. Mehmet Kesimer, senior author of the new study. "Our data shows that e-cigarettes have a signature of harm in the lung that is both similar and unique, which challenges the concept that switching from cigarettes to e-cigarettes is a healthier alternative."

The long-term adverse effects of e-cigarettes are only now starting to become clear and while they most likely don't cause the same kind of harm as cigarettes, the idea they are a "healthy" alternative may be a misnomer. The only truly healthy alternative to cigarette smoking is to simply not smoke at all.