Until the novel coronavirus came along, the two biggest concerns about vaping were whether it leads teens to start smoking conventional cigarettes and whether it can really help smokers kick the cigarette habit. Now there's a new one — whether it makes people more susceptible to COVID-19.

Young people who vape increase their risk of COVID-19 substantially, according to a recent study. Those who used e-cigarettes alone or along with conventional cigarettes were from five to seven times more likely to be diagnosed with COVID-19 than those who had never vaped.

Young people who had used both cigarettes and e-cigarettes in the previous 30 days were nearly five times more likely to experience COVID-19 symptoms.

The findings come from nationwide surveys of over 4,000 people, age 13 to 24, conducted in May 2020. People in the surveys were evenly divided between those who had used e-cigarettes and those who had never used them.

The survey respondents answered questions about whether they had ever used vaping devices or conventional cigarettes, as well as whether they had vaped or smoked in the past 30 days. They were also asked if they had experienced any COVID-19 symptoms, received a test for COVID-19 and if they had tested positive for it.

Those who had ever used e-cigarettes were five times more likely to be diagnosed with COVID-19 than non-users who had also been tested. Those who had used both e-cigarettes and conventional cigarettes were seven times more likely to be diagnosed with the disease.

There was no connection found between COVID-19 diagnosis and smoking conventional cigarettes alone. According to the researchers, very few youth use only cigarettes — most who smoke cigarettes are dual users.

Young people who had used both cigarettes and e-cigarettes in the previous 30 days were nearly five times more likely to experience COVID-19 symptoms, such as coughing, fever, tiredness and difficulty breathing. This may explain why they were also more likely to receive COVID-19 testing.

As in other recent studies, this one found that lower socioeconomic status, as well as Hispanic or multiracial ethnicity, were all linked to a higher risk of being diagnosed with COVID-19. In addition to warning teenagers and young adults about the dangers of vaping, the researchers hope their findings will prompt the Food and Drug Administration to tighten regulations governing how vaping products are sold to young people.

“Now is the time,” said senior study author, Bonnie Halpern-Felsher, Professor of Pediatrics at Stanford Medicine. “We need the FDA to hurry up and regulate these products. And we need to tell everyone: If you are a vaper, you are putting yourself at risk for COVID-19 and other lung disease.”

For more information, see the study in the Journal of Adolescent Health.