There is no safe way to vape, period. That reality is reinforced by nearly 200 cases of severe lung illnesses among vapers in 22 states, all reported since June. An adult in Illinois who recently used e-cigarettes died from an unexplained lung problem – possibly the first vaping-related fatality. State health departments and the federal Centers for Disease Control (CDC) are spreading word of the risk. "The severity of illness people are experiencing is alarming and we must get the word out that using e-cigarettes and vaping can be dangerous," says Dr. Ngozi Ezike, a Nigerian-educated pediatrician who's director of the Illinois Public Health Department.

Electronic cigarettes were developed in China in 2003 and introduced here four years later. Each is a handheld, battery-powered vaporizer that simulates smoking without tobacco or burning. Users inhale an aerosol, commonly called vapor and sometimes flavored or laced with nicotine, an addictive ingredient in regular cigarettes. CDC data says that 21 percent of high schoolers use e-cigarettes, up from just 1.5 percent in 2011. For middle-school students, vaping rates rose from 0.6 percent in 2011 to 4.9 percent last year.

The peril of vaping hit home this summer for some young users. Eight Wisconsin teens were hospitalized for serious lung damage apparently caused by vaping. Some had to be put on ventilators in the intensive care unit. During the first week of August, four Minnesota teens were hospitalized for a week or longer because of vaping-related lung troubles, prompting the state's health department to issue a warning against e-cigarettes. In Florida, 18-year-old Chance Ammirata went to an emergency room with chest pain and soon had surgery for a hole in his lung. The teen, who hadn't smoked tobacco, started using Juul e-cigarettes at 16. He and doctors blame them for his injury, so the high schooler started a #LungLove social media campaign that urges: "Throw out your Juul." He calls e-cigarettes a "nicotine-filled flash drive," and was interviewed on CBS News about his crusade. "We don't need more evidence telling us just how bad it is," Ammirata posts on Instagram. "How many more kids are going to have to get hospitalized?"

Similar messages come from those who're studying the rise in hospital admissions linked to vaping. "Our understanding of e-cigarettes is still accumulating, but at this point, we are pretty confident that e-cigarettes are at least two-thirds to three-fourths as bad as cigarettes," says Stanton Glantz at the University of California-San Francisco. He's a medical professor in the school's Center for Tobacco Control Research and Education. "Vaping is like, instead of jumping out of the 40th story of a building, you’re jumping out of the 30th story." Preliminary research studies suggest that e-cigarette smokers are more likely to suffer from heart disease and stroke. In response to these alarms, an industry trade group called the American Vaping Association insists the devices are safe and that marijuana or illegal drugs used with e-cigarettes cause the acute lung injuries.

Anti-vaping crusader says: "I didn't know I'd be able to reach people from all around the world. It really just touches my heart." – Chance Ammirata, 18, of Florida

Family doctor says: "We need pure air. That's all our lungs need." – Dr. Mini Matthew of Neptune, N.J.

Hospital administrator says: "We're seeing a pattern of lung injury [among teen e-smokers] that we've not seen before. On the chest X-ray, the whole thing looks abnormal, and it looks abnormal equally throughout the entire lung. . . . They don't fit anything else that we had previously worked on [or] understood about lung disease that's more typical in teens." – Dr. Emily Chapman, chief medical officer at Children's Minnesota Hospitals