Emergency room visits in Virginia by people who reported vaping more than doubled between 2020 and 2023, according to a data analysis released this week by the Virginia Hospital & Healthcare Association.

In 2020, there were 23,630 emergency room visits by patients who vaped, according to the organization. By 2023, that number had risen to 49,356 visits, a 108.9% increase.

ER visits by people who reported using traditional tobacco products like cigarettes and chewing tobacco dropped by about 25% during the same period, but traditional tobacco products “still account for the majority of [emergency department] visits with a tobacco or vaping-related diagnosis,” according to a VHHA news release.

The data doesn’t necessarily reflect the health risks or safety of various products. Julian Walker, a spokesman for the VHHA, said the data encompasses both people visiting the ER with a persistent cough that’s tobacco-related or patients who have other illnesses like the flu who disclose that they use tobacco.

“Taken together, the trend data may suggest a shift away from traditional tobacco products in favor of e-cigarettes and vaping devices among some users of these products,” the VHHA said in a news release.