Teenagers are a formidable force in America, but some of the things they do suggest they sometimes still need adult guidance. In particular, navigating the world of addictive substances hasn’t been easy for them, especially considering how easily accessible many of those substances are now. Vapes and e-cigarettes, specifically, have become ubiquitous, and some teens are feeling the consequences of using them.

In a report from the New York Times on Monday, teachers at Cape Elizabeth High School in Maine expressed concerns that their students are medically addicted to vaping — to the degree that some show symptoms of withdrawal when the devices are taken away. One student, the Times reports, even asked “if she could stand at the back of the class and shake her foot when she started to feel the twitch to vape.” While studies have suggested that vaping, which doesn’t rely on cancer-causing combustion, is indeed safer than cigarettes, that doesn’t mean they’re objectively safe: Vape juice still contains nicotine, a very addictive substance.

Woman vaping
Teenagers are becoming medically addicted to vaping, a new report shows.

Companies like Juul, which make some of the most popular vapes, contend that their products are meant to help people stop smoking. Since withdrawal from nicotine cigarettes can be painful, vapes provide lower doses of nicotine to help ease the symptoms. But those low doses themselves may be able to cause addiction, especially to people who haven’t smoked before. In January, a panel from the National Academies of Sciences, Engineering, and Medicine reviewed the available scientific literature on vaping and concluded that they can indeed be addictive if they contain nicotine.

In addition to fears about addiction, teachers and experts are worried about vaping because nobody knows what its long-term effects are. Since vaping is a relatively new technology, there hasn’t been time to study its effects on the health of chronic vapers. Some other chemicals in vape juice have been shown to be toxic, and anti-smoking advocates maintain that vaping may act as a gateway drug to actual cigarette smoking.

In the New York Times report, however, teens seemed completely put off by cigarettes, suggesting that anti-smoking messaging has been effective. The issue, now, is figuring out how to rebrand vaping appropriately so that teens (and adults) don’t conflate relative safety with actual safety.

Concerning as it is, the phenomenon of teen vaping addiction shouldn’t come as a surprise. We’ve known about nicotine addiction for centuries, and that’s why, as Bill Nye told Inverse, it’s likely that vaping will still be around in the next 100 years.