23 (Supplement 3): iii10iii16
Behavioral Changes Big shifts in personality or mood Being secretive about where they go or who theyre with Getting defensive over small questions Losing interest in hobbies or things they used to care about Trouble at work or school Unusual sleep patterns or eating habits that go beyond the typical changes in adolescence Physical Signs Red or bloodshot eyes, or pupils that seem unusually large or small Frequent nosebleeds or a constantly runny nose (without being sick) Poor hygiene or changes in grooming Unexplained injuries, bruises, or marks Shaky hands, slurred speech, or other changes in coordination A persistent cough or raspy voice Social and Financial Signs Hanging out with a new crowd they wont talk about Missing money or valuables Financial struggles or suddenly asking for money Pulling away from close friends or family Legal trouble or risky decisions No single sign means something is definitely wrong

however, cells are not killed outright by SIMH, so effects on human health may take time to develop, as is also the case with conventional cigarette smoking
CDC: E-Cigarettes (Vapes) Center for Disease Control webpage with information about vaping and its health impact
Being exposed to smoke at a young age can increase the risk of: Sudden infant death syndrome or cot death Developing asthma in childhood Having an asthma attack if the child is already affected by this condition Experiencing more frequent coughs and colds Middle ear infections, which can sometimes affect the hearing Chest infections such as pneumonia and bronchitis in babies and children Chronic bronchitis caused by irritation of the lungs Needing to be admitted to hospital if a chest infection occurs Long term exposure to smoke can also increase the risk of lung cancer, heart disease and other serious conditions