Electronic cigarettes are sometimes billed as a safer alternative to smoking tobacco, but there is still a lot that medical professionals don't know about "vaping."
"A lot of the products are so new that the research is still being done," said Chantal Fields, area director of the American Lung Association of West Virginia. But some of what is known about e-cigarettes is of concern, she said.
One study, by the health watchdog group the Center for Environmental Health, found that 97 e-cigarettes and vaping products had high levels of formaldehyde and acetalehyde, which are cancer-causing chemicals. Vape "e-juice" (the liquid that is poured into the e-cigarettes for users to inhale) also has high concentrations of nicotine. The juice can poison a child who drinks it and burn the skin it comes in contact with, Fields said.
E-juice often comes in colorful bottles and is often candy-flavored.
"We are seeing kids poisoning themselves because it looks like candy and it's not," Fields said. There's no research that shows e-cigarettes are safer than traditional tobacco products, Fields said.
A chemical found in some electronic cigarettes, diacetyl, has been linked to debilitating lung disease. Diacetyl is used in butter flavoring.
Citing a 2002 report from the National Institute for Occupational Safety and Health, The Washington Post reported eight workers in a microwave popcorn plant in Missouri developed bronchiolitis obliterans - known as "popcorn lung" - after they breathed diacetyl on the job. Four of the workers needed lung transplants and five died of respiratory causes, according to The Washington Post.
Vaping advocates say the jury is still out on whether diacetyl and a similar chemical, acetyl propionyl, are dangerous to e-cigarette users.
"Those cases in which diacetyl was seen directly to cause broncholitis obliterans were cases in which workers were exposed to an actual vapor from heated flavorings," Oliver Kershaw, founder of the E-Cigarette Forum, wrote in a blog dated July 3, 2015, on vaping.com. "Despite the name, vaping itself is actually not, in the main, the inhalation of a vapor, but of an aerosol. In an aerosol, the particles from the gaseous phase have condensed into larger droplets.
"It's unclear whether these droplets are capable of depositing DA/AP deep within the lung," he wrote.
According to the Centers for Disease Control and Prevention, more and more teenagers are picking up e-cigarettes. Vaping among middle and high schoolers tripled from 2013 to 2014, according to CDC data released in August. Findings from the 2014 National Youth Tobacco survey show that among high school students, current e-cigarette use (defined as on at least one day in the past 30 days) went from 4.5 percent to 13.4 percent in 2014. Among middle schoolers, the numbers went from 1.1 percent in 2013 to 3.9 percent in 2014.
"We want parents to know that nicotine is dangerous for kids at any age, whether it's an e-cigarette, hookah, cigarette or cigar," CDC Director Dr. Tom Frieden said in a statement. "Adolescence is a critical time for brain development. Nicotine exposure at a young age may cause lasting harm to brain development, promote addiction and lead to sustained tobacco use."
The American Lung Association's official position on e-cigarettes is that the organization is "very concerned" about the potential health consequences of vaping and about the unproven claim that they can be used to help a person stop smoking, according to an ALA statement last year.
Similarly, the American Heart Association has also encouraged caution about vaping.
"E-cigarettes are dangerous because they target young people, can keep people hooked on nicotine, and threaten to re-normalize tobacco use," the AHA said in a statement on its website. "Analysis of the limited data suggested that e-cigarettes did appear to be less harmful than traditional cigarettes and - as a last resort - may help people quit smoking.
"But those finds were accompanied with warnings that the observations were based on a limited pool of medical research and there were no long-term results," the statement said.
The Food and Drug Administration does not currently regulate e-cigarettes.
"There is little or no regulation of this product because it's not a traditional tobacco product - it doesn't fit the current FDA definition of the cigarette, therefore it's not regulated federally," Fields said. "Any regulation is left up to states."
In West Virginia, people have to be 18 before they can purchase e-cigarettes.
"It's a regulation not every state has," Fields said.
Reach Lori Kersey at Lori.Kersey@wvgazettemail.com, 304-348-1240 or follow @LoriKerseyWV on Twitter.