As questions persist about the effects of e-cigarettes and vaping on young people’s health, a school district in South Carolina is increasing penalties on students caught with any nicotine-related devices.

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Horry County Schools implemented a new policy mandating an automatic suspension of up to five days for students caught vaping at school, according to WMBF-TV.

The district’s previous policy called for a two-day in-school suspension.

The increased punishment comes after administrators voiced concerns about vaping by high school students and even middle schoolers, WMBF reported.

"Vaping has really become popular within the last few years and it's become quite an issue and a distraction to our students and to the learning environment," Horry County Schools spokesperson Lisa Bourcier told the news station.

“We had some infractions in place for that, but we have received feedback from our school administrators that the blatant use of that needs some stricter infractions," she said.

The American Lung Association has said it is "very troubled by the evolving evidence about the impact of e-cigarettes on lungs," CNN reported. The organization said research shows that main vape ingredients might harm cells or contain "dangerous chemicals" that can cause lung and cardiovascular disease.

The prevention director at Shoreline Behavioral Health Services, Jessie Marlowe, told WMBF that the long-term effects of vaping are still unknown.

“We had actually seen a decline for a little while on tobacco use among youth until we started seeing vaping, Marlow said.

“We’ve seen a huge increase in youth in our county using vaping-style products, whether it’s cigarettes or vape pens," she said.

Since late July, 14 teenagers in two states have been hospitalized with severe lung disease and breathing problems possibly linked to vaping.