Like gun powder, the electronic cigarette is a Chinese invention. Electronic cigarettes, also known as e-cigarettes or e-cigs, are battery-operated devices that deliver liquid nicotine, flavor and other chemicals inserted in cartridges. An atomizer heats the liquid into a vapor that is inhaled (called “vaping”) and creates a vapor cloud resembling tobacco smoke. Most e-cigarettes are manufactured to look like conventional cigarettes, cigars or pipes, including a glowing tip. Some resemble items such as pens, USB memory sticks or flash drives. The first e-cigarettes came out on the market in 2004.

E-cigarettes are marketed as a safe alternative to smoking tobacco-based cigarettes and as a way for a smoker to get nicotine in locations where smoking is not permitted. However, they are not necessarily a safe alternative. E-cigarette makers claim the ingredients are safe, but this only means they have been found to be safe to eat, not to inhale. Since e-cigarettes are not labeled with their ingredients, it is unclear how much nicotine and other substances a person gets from each cartridge. E-cigarettes contain known carcinogens and toxic substances such as formaldehyde and acetaldehyde as well as potentially toxic metals and nanoparticles from the vaporizing mechanism.

Besides being an addictive drug, nicotine is toxic in high doses. Once used as an insecticide, nicotine affects the brain, nervous system and heart, raising blood pressure and heart rate. The larger the dose of nicotine, the more a person’s blood pressure and heart rate go up. This can cause an abnormal and irregular heart rate (arrhythmia). In rare cases, especially with large doses, rapid, irregular heartbeats can cause heart failure and death.

After the initial effects wear off, the body starts to crave nicotine. An e-cigarette user may feel tired, depressed or crabby due to nicotine withdrawal and crave more nicotine to perk up again. Over time, nicotine can lead to serious problems, including heart disease, blood clots and stomach ulcers. Studies show e-cigarettes can cause short-term lung changes like those caused by regular cigarettes.

E-cigarette products are not regulated by the Food and Drug Administration, so there are no accepted measures to confirm their purity or safety, and long-term health consequences remain unknown. When the FDA analyzed samples of two popular brands of e-cigarettes, it found variable amounts of nicotine and traces of toxic chemicals, including known carcinogens, prompting the FDA to issue a warning about the potential health risks. The National Institute on Drug Abuse is developing research programs to help answer these questions.

An adverse event is an undesirable side effect or unexpected health or product quality problem that can be reported to the FDA. Consumers, health professionals and concerned members of the public have reported adverse events involving e-cigarettes including hospitalization for illnesses such as pneumonia, congestive heart failure, disorientation, seizures and hypotension.

Until more is known about the potential risks, the safe plan is to avoid electronic cigarettes. If you want to stop smoking, many FDA-approved medications are safe and effective for this purpose.

In a recent study, Penn State researchers concluded users of e-cigarettes report fewer cravings, less irritability and believe they are less addictive than regular cigarettes. However, e-cigarettes are not shown to be effective with smoking cessation. It has also been suggested they could continue the nicotine addiction and actually interfere with quitting.

Since 10 states and the District of Columbia still permit e-cigarette sales to minors, more than 16 million U.S. children can buy them legally. A 2013 Centers for Disease Control and Prevention study showed ecigarette use among middle school and high school students doubled between 2011 and 2012, with 10 percent of high school students and 3 percent of middle school children using them and risking addiction to nicotine. Among high school e-cigarette users, 80 percent smoked regular cigarettes as well.

Because nicotine is so addictive, the best way to avoid health problems is to never start smoking or vaping. While children and teens do not consider how their current behaviors affect their future health, it is important to talk with them about it. Focus on immediate drawbacks such as less money to use on other things. If your teen smokes and wants to quit, e-cigarettes are not the way to go. Using an e-cigarette mimics the experience of smoking regular cigarettes more closely than any other quitting options. Instead, encourage your teen to try nicotine gum or a nicotine patch, which will prevent withdrawal symptoms.

Children are quick to observe the contradictions between what their parents say and what they do, so if you smoke or vape, consider quitting. It’s not simple and it may take a few attempts and the help of a program or support group. Your children will be encouraged as they see you overcome the addiction.

Expect to see more information and research studies about e-cigarettes and their health effects. California already declared electronic cigarettes a health threat and urges tougher regulations. Other states including Oklahoma, Tennessee and Arkansas issued advisories cautioning about the use of e-cigarettes.

The e-cigarette boom is spawning the sales of electronic cigars, e-hookahs and other devices using vaporized liquids to mimic different types of smoking. Even less is known about their ingredients and safety, and they need to be researched and regulated.

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.