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Moreover, flavouring agents such as diacetyl have been implicated in chronic respiratory conditions, and emerging studies suggest that chronic e-cigarette exposure may lead to DNA damage, impaired repair mechanisms, and oxidative stresshallmarks of carcinogenesis

Common symptoms may include: Unexplained weight loss Fatigue or weakness Pain or discomfort in certain areas of the body Changes in skin appearance or texture Persistent cough or hoarseness Difficulty swallowing Persistent indigestion Changes in bowel or bladder habits Unusual bleeding or discharge Reducing the risk of cancer from tobacco involves quitting tobacco use altogether

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"A Practitioner's Guide to Electronic Cigarettes in the Adolescent Population"