Vaping is a serious concern in the United States. Not too long ago, a New York Attorney General Letitia James took a strong stand against e-cigarette manufacturers and distributors. James filed a lawsuit accusing them of fueling a youth vaping crisis. The lawsuit alleges that these companies that manufacture vapes, especially with flavors have misled consumers about the safety of their products while deliberately targeting young people through deceptive marketing.

In 2017, a median of 4.6% of US adults were considered current users of e-cigarettes or similar devices. The number has only been up ever since. Based on the 2017 surveys and federal data, here is list of the top states the US where most youth vapes.

At 10 and 9, we have Ohio and Colorado

In Ohio, the data presents a total of 5.33% of vape users, while 12.2% among them are adults between the age 18 to 24. The Ohio Department of Health announced that it would allocate $4 million for initiatives to curb vaping.

With the same number stands Colorado, where 13.5% makes the adult population between the age of 18 to 24. The cause of concern here is that 26.2% of them are high school students.

Number 8: Nevada

At number 8, we have Nevada, with a total of 5.4% of vape users, with 12.4% being adults between 18 to 25 and 15.5% in high school.

Number 7: Arkansas

In Arkansas, a total of 5.66% use vape, among them 14.7% are adults between 18 to 24 while 13.9% are high schoolers.

Number 6: West Virginia

In West Virginia, 5.67% people use vape, among them 10.9% are adults between age 18 to 24, while 14.3% are high schoolers.

Number 5: Wyoming

Wyoming reported a total of 5.8% vape users, and 15.2% of them were adults age between 18 to 24.

Number 4: Tennessee

Around 1 in 5 adults an 1 in 10 high schoolers in Tennessee smoked in 2017. The overall average of vape users are 5.9%, with 14.5% of adults and 11.5% high schoolers.

Number 3: Indiana

The overall average is at 6%, with 11.3% being adults age between 18 to 24.

Number 2: Kentucky

The overall average here is at 6.1%, with adults being 13.1% and high schoolers at 14.1%.

Number 1: Oklahoma

This is no surprise, if someone has ever watched the series Friends, when Chandler gets transferred at Oklahoma, where everyone smokes. The state too tops here for smoking and vaping, with an overall of 7.1% of users, with 15.4% being adults age between 18 to 24 and 16.4% highschoolers.

Vaping, A Concern

Vaping has become a more common form of tobacco use among American middle and high school students. As per the Centers for Disease Control and Prevention or CDC, nearly 1.6 million students used e-cigarettes in 2024, with 87.6% of them opting for a flavored product. It is the flavor that makes it even more addictive, and people want to keep smoking it, resulting in it being emptied and refilled way more quickly. This means those who smoke flavored cigarettes consume more tobacco than those who smoke unflavored ones. Although overall youth vaping rates have declined by almost 70% since their peak in 2019, health officials say the industry’s marketing tactics remain a serious concern.

When it comes to chronic diseases, your genes might have a say, but they are not everything. A massive review of 483 studies shows that seven everyday habits can seriously shrink your risk of developing long-term health problems, even if your DNA is not exactly on your side. These habits make up Life’s Simple 7, backed by the American Heart Association, and they do more than just protect your heart; they help pretty much your whole body run better.

Here is how each one works:

1. Quit Smoking

If you smoke, stopping is hands down the best thing you can do for your health. Cigarettes do not just mess with your lungs; they quietly wreck your heart, blood vessels, and even your brain. The toxins cause chaos all over, raising your chances of everything from strokes to high blood pressure. But the good part is that the moment you stop, your body starts to bounce back.

2. Move More

Think of sitting too much like being stuck in slow traffic; every system gets backed up. Regular movement, even just 30 minutes a day five times a week, can make a real difference. It lifts your mood, improves your circulation, keeps your blood sugar steady, and helps with weight control. Whether you like dancing in your living room, cycling, or walking your dog around, just keep your body in motion.

3. Eat Nutritious Food

No one is asking you to live off green vegetables. Just get more real food on your plate like fresh vegetables, fruits, whole grains, healthy fats, and lean proteins. These foods fight inflammation, fuel your metabolism, and keep blood sugar swings in check. Give up on unnecessary ingredients and sugar overloads.

4. Watch Your Weight

It is not about squeezing into skinny jeans. Carrying extra fat, especially around your waist, raises your risk of diabetes, heart disease, and other chronic issues. Managing your weight with good food and regular activity keeps pressure off your organs and helps dial down the kind of inflammation that quietly fuels disease.

5. Keep Blood Pressure in Check

High blood pressure rarely shows up with warning signs, but it can do real damage behind the scenes. It strains your heart, wears out your arteries, and messes with your kidneys. Staying in the healthy range often comes down to the basics like moving more, eating less salt, getting enough potassium, and managing stress where you can.

6. Steady That Blood Sugar

If your blood sugar runs high for too long, it starts harming everything from your nerves to your kidneys. A healthy diet and regular movement can keep it under control, even if diabetes runs in the family. Swap out white bread for whole grains, eat meals at regular times, and try not to include sugar in everything.

7. Mind Your Cholesterol

Not all cholesterol is evil, but the bad kind can clog up your arteries like gunk in a pipe. However, you can raise your good cholesterol and lower the bad with a few key choices, like eating more fibre, cutting back on saturated fats, and getting moving. The result is smoother circulation and a lower risk of heart problems.

You cannot pick your genes, but you can choose your habits. These seven lifestyle changes are a powerful strategy to delay or even prevent chronic diseases, regardless of hereditary risks.

Diagnostic Anomaly' is a Health And Me Series, where we dive deep into some of the rarest of rare diseases. Here, we trace such diseases and what causes them. We also try to bring case studies around the same.

It started with what seemed like a routine emergency room visit. A man in his 60s walked in after falling on his backside, complaining of knee pain. But when he also mentioned discomfort in his groin, doctors decided to investigate further. What they found stunned even seasoned physicians: X-rays revealed bone formation inside his penis.

This extraordinary case led to a diagnosis of penile ossification, a rare and majorly understood medical anomaly where bone forms within the soft tissue of the penis. Only about 40 of such cases have ever been documented in medical literature. The condition, while rare, is a window into the complex play between chronic inflammation, metabolic disorders, and tissue response in the human body.

What Is Penile Ossification?

Penile ossification is the development of 'extraskeletal' bone tissue within the shaft of the penis. Unlike the baculum, a penile bone found in many mammals including dogs, bats and gorillas humans do not have a natural penile bone. So when ossification occurs in human males, it is considered a pathological response, not a biological norm.

This abnormal process typically results from metaplasia, a condition in which one type of tissue transforms into another as an adaptive, but misguided, response to chronic stress or injury. In this case, soft connective tissues in the penis begin to harden and calcify, forming actual bone.

How It Is Linked to Peyronie’s Disease?

In many cases, penile ossification has been associated with Peyronie’s disease, a condition that causes fibrous scar tissue to develop inside the penis. This scar tissue can lead to curvature during erections, discomfort, and even sexual dysfunction. In the current case, while the patient declined follow-up and a complete diagnostic workup, physicians suspected Peyronie’s disease may have contributed to the ossification process.

Peyronie’s disease affects about 1 in 10 men, primarily between the ages of 40 and 70, and its exact cause is still debated. It’s thought to develop following trauma—either acute or from repetitive microtrauma—that causes bleeding and inflammation inside the penis. The body tries to heal this damage with scar tissue, and in rare cases, this process can spiral into ossification.

Triggers for Ossification

While Peyronie’s is a common thread in reported cases of penile ossification, it's not the only one. Researchers have linked the condition to:

• End-stage renal disease, which can cause calcium-phosphate imbalances.
• Metabolic disorders, including diabetes.
• Repeated trauma, either from accidents, certain sexual activities, or aggressive treatments.
• Chronic inflammation, possibly from autoimmune issues or infections.

Any of these conditions can prime soft tissue to start calcifying, setting the stage for ossification.

In this case, however, physicians were left in the dark. The patient left the hospital against medical advice and did not return for further evaluation. That means key tests—such as blood work to assess calcium levels, kidney function, and inflammation markers—were never performed. As a result, the exact cause of his penile bone formation remains unknown.

How Does It Present, and What Does It Feel Like?

Men with penile ossification often report painful erections, difficulty during intercourse, and significant psychological distress. Some describe their penis as feeling abnormally rigid or even "like bone," which, as this case illustrates, may not be a metaphor. Curvature can become extreme—approaching 90 degrees in some documented cases—and may not respond to conservative treatments like verapamil injections or physical therapy.

This is not just a sexual or cosmetic concern. In many cases, the condition severely impairs quality of life, making intimacy difficult or impossible and leading to emotional distress, depression, and anxiety.

How Is Penile Ossification Diagnosed?

Because the condition is so rare, misdiagnosis is common. Penile ossification may initially be mistaken for calcified plaques, common in Peyronie’s, or even dismissed as a psychological issue. However, pelvic X-rays or penile ultrasound can clearly show the presence of bony structures within the penis. CT scans and MRI may be used in more advanced cases to assess the extent of ossification.

In this patient’s case, the diagnosis came almost by accident—an X-ray taken to assess potential fractures in the pelvis ended up capturing the penile bone formation.

Treatment and Managing the Physical and Emotional Burden

Treatment for penile ossification depends on severity and cause. If the bone formation is limited and not causing significant distress, conservative management may include:

• Topical anti-inflammatories
• Oral pain relievers
• Steroid or verapamil injections

In more advanced cases, shockwave therapy—using focused sonic waves to break down hardened tissue—may offer relief. Surgical intervention, including penile reconstruction or prosthesis, might be considered when curvature or ossification causes severe dysfunction.

That said, treatment outcomes vary. And because so few cases exist, there's limited consensus on best practices. What’s clear is that patients benefit from a multidisciplinary approach, involving urologists, endocrinologists, and mental health professionals.

Although penile ossification is rare, it's likely underdiagnosed, especially among men who delay seeking help due to embarrassment, stigma, or misinformation. Recognizing the early signs—such as painful erections or significant curvature—can help men get diagnosed sooner, before the ossification worsens.

It’s also a reminder that the body can respond to injury in unexpected ways. Something as seemingly routine as a fall, combined with underlying health issues, may trigger a rare and life-altering condition. For physicians, this case underscores the importance of listening carefully to patient complaints, even those that seem tangential to the original reason for a visit.

The patient who walked into the ER that day may never know what caused the bone to grow in his penis. And since he opted out of treatment, we may never know how his condition progressed. But his case joins a short list of documented penile ossification instances, each one helping to shed light on a condition that many doctors have never seen—and many patients never knew existed.

As research continues and awareness grows, the hope is that men suffering from this painful and rare condition can find answers, support, and a path to recovery that respects both their physical and emotional well-being because in medicine, even the rarest cases matter.

It is true that lung cancer is commonly seen among smokers. About 85 per cent of all lung cancers are directly related to tobacco use, especially smoking. However, nearly 10–20 per cent of lung cancers each year occur in people who have never smoked or who have smoked fewer than 100 cigarettes in their lifetime.

It is also the fifth most common cause of cancer-related death worldwide. Even if you have never smoked in your life, there is a possibility that you may still get lung cancer. While smoking has traditionally been seen as the leading culprit, other risk factors are increasingly being recognised.

Pollution, Family History and Hidden Risks

“We have seen that there are many other factors which may lead to the development of lung cancers. The most important ones are air pollution, especially in Southeast Asia and the Indian subcontinent," says Dr Kamran Ali, Principal Consultant, Lung Transplant and Thoracic Surgery, Max Super Speciality Hospital, New Delhi. He explains that pollutants from vehicles and industry, such as benzene and heavy metals, can contribute to lung cancer risk.

Long-term exposure to polluted air may cause persistent inflammation in the lungs, weakening the immune system and making it easier for cancer cells to grow. He warns about exposure to radon gas, which is found in soil and can sometimes creep into homes.

Long-term exposure to second-hand smoking or third-hand smoking also increases risk, says Dr Ali, pointing out that many people underestimate these dangers. He adds that genetic susceptibility also plays a role: "If your parents have lung cancer or your sibling has lung cancer, it does increase the risk of lung cancer for you as well.”

He also explains a lesser-known cancer, saying, “There is a separate intake entity called mesothelioma which arises from the surface of the lung. It is not from the lung itself. It is from the surface of it which is associated with asbestos.” Although asbestos is now banned, it was previously used in roofing and packaging industries. Dr Ali cautions against exposure to other heavy metals like chromium.

How Non-Smoker Lung Cancer Differs

Non-smoker lung cancers are slightly different from smokers’ lung cancers. “Classically, non-smokers’ lung cancer is usually an adenocarcinoma, which is found in the outer third of the lung surface,” he explains, adding that it often presents more vaguely than smoking-related cancers: “It also presents as a vague or a diffuse involvement of the lung rather than like a nodule or a mass.”

Dr Ali says it is typically slow-growing and less likely to spread to other parts of the body compared to lung cancer in smokers.

Watch for the Silent Signs

So lung cancer is a silent killer. If you have symptoms like a cough that worsens over time or a cough that does not go away, blood while you cough, unexplained weight loss, shortness of breath, or chest pain, you need to consult your local thoracic surgeon. The expert stresses that early detection is critical for effective treatment.

Prevention Starts with Awareness

To lower your risk, Dr Ali shares these preventive measures:

• Refrain from venturing out of your house when the air pollution level is in a severe state outside.
• If necessary to go outside, use an N95 mask in polluted areas.
• You should use air purifiers indoors to filter out harmful particles.
• Incorporate fresh fruits and vegetables in your daily diet.
• Drink plenty of water to keep you hydrated.
• You can practise some appropriate breathing exercises to enhance your lung function.
• If you have a strong family history of lung cancer, you must meet a thoracic surgeon or oncologist to get yourself evaluated.