When electronic cigarettes entered the market in 2004, they were billed as a healthier alternative to smoking cigarettes and a viable means to help kick the habit for goodElectronic Cigarettes: A short review. Bertholon JF1, Becquemin MH, AnnesiMaesano I, Dautzenberg B. S. Karger, AG, Basil. 2013 Sept 24; Abstract.. Recently, however, the safety of the futuristic smoking sticks has come under scrutiny. Critics maintain that e-cigs may pose health risks of their own, including exposing users to carcinogens, and the question of whether they actually serve as effective quitting aids for smokers is also up for debate. So… that’s confusing.

To help get to the bottom of all this contradictory info, the Food and Drug Administration has commissioned several studies to determine the long-term effects of using e-cigarettes. To puff or not to puff? Here’s what we know so far.

What’s the Deal?

Electronic cigarettes are battery-operated devices that turn nicotine, flavor, and other chemicals into a vapor that’s inhaled by the user (the vapor is created when the device heats up). Because they deliver nicotine without burning tobacco, e-cigarettes are purported to be safer and less toxic than conventional cigarettes.

Despite these claims, there’s still no real data on the effects of e-cigarettes (positive or negative), yet marketing materials still bill them as a healthy choice. E-cigs are currently advertised to roughly 24 million people ages 12 to 24; since 2010, the number of advertisements has more than tripled.

There’s an absence of data when it comes to knowing whether e-cigs are as healthy an option as advertisements claim.

It’s perhaps alarming that these marketing campaings have continued unchecked, because the list of unanswered questions about e-cigs is a long one. Questions yet to be answered include how much nicotine or other harmful chemicals are being inhaled during use, what’s in the emissions, whether there are any benefits to using these devices (i.e., will they really help smokers quit), and whether e-cigarettes will cause young people to start smoking or try other tobacco products.

So far, the U.S. Food and Drug Administration has channelled $270 million towards 48 research projects in an effort to answer these questions. But the data is hardly quick to come by. According to some researchers leading the FDA-funded projects, we might not have concrete information about e-cigs until 2018.

Once the FDA has the basic authority to regulate the products (something that could happen in the next year) it shouldn’t take long to establish a regulatory framework. In fact, some regulations have already been proposed, including banning the sale of e-cigs to people under 18, putting health warning labels on packages, and requiring an approval process for current and future e-cigarette manufacturers.

Why It Matters

Experts from the American Cancer Society maintain that the safety of e-cigs, not to mention their effectiveness as a cigarette substitute, is not supported by science. And because safety is not guaranteed, users who opt for electronic cigarettes over the traditional kind may simply be swapping one unhealthy habit for another. Experts also worry that e-cigs may motivate young people to try traditional cigarettes.

Users who opt for electronic cigarettes over the traditional kind may simply be swapping one unhealthy habit for another.

So what do the studies say? For the most part, the verdict is still out. But while the FDA works toward its own conclusions about the safety of electronic cigarettes, other studies point to potential negative health effects. A recent CDC study found that the number of calls to poison centers resulting from adverse reactions to e-cigarette liquids increased from one call per month in September 2010 to 215 per month in February 2014 (Conventional cigarettes did not show a similar rise in poison reports during the same time period.). The most common reactions mentioned during calls to poison centers were vomiting, nausea, and eye irritation.

One study that looked at the short-term effects of e-cigarettes on a variety of people (in a small sample size) found that both smokers and participants who had never smoked experienced a statistically significant increase in airway resistance after smoking e-cigs. According to the researchers, these results suggest that e-cigarettes can cause immediate harm after smoking. More research is needed to determine whether these negative effects also last long-term.

Then there’s the question of whether e-cigs help smokers quit in the first place. One study found that participants who used electronic cigarettes were 60 percent more likely to report success in quitting smoking than those who used over-the-counter nicotine patches (or other similar replacement therapies) or those who tried to quit cold turkey. Another study found that the devices (with or without nicotine) were “modestly effective” in enabling people to quit smoking, similar to nicotine patches. But the researchers also noted that more research is needed (shocking, we know) to establish whether the potential benefits of e-cigs would outweigh the increasingly documented harms.

The Takeaway

The word is still out on e-cigs—but it’s looking more and more likely that they’re not as healthy an option asadvertisements maintain. One thing that’s clear is that more research into the health and efficacy of these products is needed. Stay tuned in 2018, when the FDA will hopefully reveal its answers! And in the meantime, maybe try some alternative options for nipping smoking in the butt.

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