Deemed “safer,” electronic cigarettes, also known as e-cigarettes or e-cigs, have earned a reputation as an alternative for traditional cigarettes. There’s a hot debate about whether traditional cigarette users should switch to e-cigs, which are supposed to be less harmful for your health. But there is little evidence to support the switch.

What Are E-Cigs?

Unlike traditional cigarettes that deliver nicotine by burning tobacco leaves, e-cigs are battery-operated devices that deliver nicotine with flavorings and other chemicals to users in vapor instead of smoke. They come in different shapes and sizes. Some resemble traditional cigarettes, cigars or pipes, and others resemble everyday items, like pens. There are currently more than 250 different e-cig brands on the market.

In 2014, the Centers for Disease Control and Prevention reported that 12.6 percent of U.S. adults had tried an e-cig, and 3.7 percent regularly used them — including 2.4 million middle and high school students who regularly used in the past 30 days.

How Do E-Cigs Work?

E-cigs are made of three components:

— A cartridge, which holds a liquid containing varying amounts of nicotine, flavorings and other chemicals

— A heating device that vaporizes the liquid

— A power source (usually a battery)

Puffing on an e-cig activates the battery-powered heating device, which vaporizes the liquid in the cartridge into an aerosol that is inhaled — a process popularly known as vaping.

[See: How to Break 7 Unhealthy Habits.]

Are E-Cigs Safer Than Traditional Cigarettes?

At this time, there isn’t sufficient research available to support that e-cigs are safer. Smoking traditional cigarettes remains the leading cause of preventable death and sickness in the U.S., with more than 480,000 people a year dying of smoking-related illnesses. The adverse health effects caused by traditional cigarettes are due to the harmful tar and chemicals they contain. E-cigs are designed to simulate the effect of traditional cigarettes by providing nicotine through an aerosol that feels and looks like tobacco smoke without the harmful tar and other chemicals. Although e-cig vapor doesn’t contain some of the harmful materials found in tobacco smoke, little is known about the health risks of using these devices. Laboratory analyses have shown that the vapor from some e-cigs contains substances that cause cancer and have adverse effects on the heart, blood vessels and lungs. Glycol and propylene are common solvents used in e-cigs that produce many toxic substances when heated and vaporized. And nanoparticles released into the air from the e-cig’s heating mechanism can be toxic to the human body and the environment.

It’s still unclear whether all e-cigs produce harmful substances. This is because the voltage, temperature, shape, type and age differ from one device to another. Also, the variety of flavors and differences in nicotine levels in e-cigs make it difficult for researchers to come to a firm conclusion about the safety of these devices. What is known, though, is that e-cig devices tend to produce more harmful products when the voltage is increased and as they age.

Most e-cigs contain nicotine. Nicotine is toxic to the nervous system and highly addictive, and it is a well-studied stimulant that increases heart rate and blood pressure. Repeated exposure to nicotine through smoking, vaping or chewing products with nicotine can put people at risk for damaging their heart, lungs, mouth and throat.

In addition to nicotine, e-cig aerosols contain carbonyl compounds, such as acrolein, formaldehyde and acetaldehyde, which can cause significant cardiovascular damage and may cause irregular heart rhythm, increased blood clotting and airway irritation.

One concern with the e-cig device is that users can refill the cartridge with a higher, more toxic level of nicotine and increase exposure to potentially hazardous chemicals in the e-cig vapor. The device can also be used to deliver other drugs, as users can refill the cartridge with substances other than nicotine. This can be dangerous for anyone, particularly adolescents and young adults, who are prone to experiment with new products and devices.

Are E-Cigs Effective for Quitting Smoking?

E-cigs are used as a nicotine replacement therapy for many smokers who want to quit. Nicotine from e-cigs reduces smoking cravings and can help smokers stay away from traditional cigarettes. But recent studies cast doubt on the effectiveness of e-cigs for quitting smoking. They showed that nicotine replacement therapies are only effective when a health care provider prescribes them, not when purchased over the counter. Also, e-cigs can keep smokers as long-term nicotine users because they have similar pleasurable, addiction-reinforcing properties. As a result, e-cigs could increase the chance of starting smoking again, when compared with other cessation methods. Varenicline and bupropion are approved first-line drugs for quitting smoking that don’t contain nicotine and help smokers quit by reducing the urge to smoke. Research has shown the best method for quitting is the combination of Food and Drug Administration-approved smoking cessation products combined with continuous active engagement between individuals and their health care provider.

Despite advertising to the contrary, e-cigs impose a considerable risk of secondhand exposure. Most manufacturers claim that e-cigs produce smokeless water vapor and are therefore harmless. This is inaccurate. E-cigs do not emit pure water vapor. E-cig vapor also contains the same amount of tiny particles found in cigarette smoke that spoil indoor air quality. If inhaled, they can be deposited deep in the lungs and cause respiratory problems not only for the users, but also for anyone secondarily exposed.

[See: The 5 Latest Poison Control Threats Kids Face.]

What Is the Chance That My Child Will Use E-Cigs?

E-cig use has increased drastically among those under 18. Online marketing, appealing cartridge flavors — such as coffee, cinnamon, mint, fruit and candy — and the fancy looks of these devices have made e-cigarettes very attractive to teenagers and young adults. One study done by the FDA showed that among teens and adults, flavors are the No. 1 reason they use e-cigs. Flavors also boost the rewarding and addictive effects of e-cigs. The lower cost of e-cigs compared to conventional cigarettes also increases their availability for everyone, including young people.

E-cigs familiarize teens with nicotine products and thus could be gateways to traditional cigarette smoking. They may also increase the chance of experimenting with other substances. One study showed that high school students who used e-cigs were more likely to smoke traditional cigarettes within the next year. In other words, e-cigs have introduced school-aged children to nicotine – children who otherwise wouldn’t have used any tobacco products.

Some critics argue that frequent public e-cig use among adults familiarizes smoking behavior among children and threatens the stigma associated with smoking in society today. This may neutralize the precious efforts in the last decades that led to the decrease in smoking prevalence.

It Seems There Are Risks With E-Cig Use. How Are They Regulated?

The FDA now regulates marketing, distribution and advertisement of e-cig products. To protect young people, the FDA banned online and in-person marketing of e-cigs to minors. By the end of 2016, manufacturers will have to report which products they make and how they distribute them. By Feb. 8, 2017, they must clarify the ingredients used in their products. And by June 2018, they need to sell their products with FDA health warning labels — just like any other conventional tobacco products.

[See: 10 Concerns Parents Have About Their Kids’ Health.]

I Was Thinking of Quitting With E-Cigs. What Should I Do Now?

Health professionals highly recommend that you quit smoking to decrease your chances of heart attack, stroke and cancer, and improve your overall health. Consider talking to your doctor about your intentions to quit smoking, and ask about the current approved and effective quitting methods that you could use. If used to quit smoking, e-cigs may not be effective, possibly even augmenting addiction and increasing your dependence on nicotine. Once again, studies show that smoking cessation therapies are only effective when a doctor has prescribed them, and the FDA has approved effective therapies for quitting smoking. Even though e-cig aerosol contains less harmful substances than cigarette smoke, very limited information is available about the safety of these new devices. The FDA’s decision to regulate e-cigs is backed by many scientists and policymakers who believe that concerns about the safety of these products should be addressed. Once completed, long-term studies on e-cigs use and their health effects will provide more reliable information about their safety.

Drs. Kianoush and Tibuakuu are supported by the American Heart Association Tobacco Regulation and Addiction Center (A-TRAC).

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Electronic Cigarettes: Are They Safer Than Traditional Cigarettes? originally appeared on usnews.com