Rhode Island's top doc says electronic cigarettes are not safe. Health experts know more about what's not in them than what is in them.
What is known, according to the Centers for Disease Control, is that about 2.4 million middle school and high school students use them.
That's concerning to Dr. Nicole Alexander-Scott, director of the Rhode Island Department of Health.
"We know that they're not safe. Period," Alexander-Scott said.
Dr. Amanda Jamieson, a Brown University researcher, refers to electronic cigarettes as the large unknown black box.
"They are billing it as the safer alternative but I don't think you can really say that," said Jamieson, who specializes in lung research.
That's what led her to apply for and receive a biomedical research grant through the University of Rhode Island, so she can study the effects of electronic cigarettes on our lungs.
"It does seem to have, depending on the concentration you add, the e-cigarette extract, it is having a definite impact on the lung epithelium," said Jamieson.
That's the respiratory system. Jamieson is especially concerned about the flavored e-cigs.
"What we're finding, actually, is some of the flavors are even more toxic than the unflavored e-cigarette," she said.
And then there's the nicotine. Previous research has shown inconsistencies.
"What they found was that some of the cigarettes that said they had nicotine did not have nicotine and some cigarettes that said they did not have nicotine ended up having nicotine in them," said Jamieson.
"The FDA is working on that," Alexander-Scott said.
The U.S. Food and Drug Administration is currently working on regulation of electronic cigarettes. Rhode Island's top doc is ready.
"Here in Rhode Island, we passed regulations that require retail stores who sell e-cigarettes to become licensed," said Alexander-Scott.
There is also a law in Rhode Island that you have to be 18 or older to purchase e-cigarettes. The reality, though, is millions of teenagers in this country under the age of 18 are using them. The added flavors are a big draw.
"They're vapors, but the vapors are filled with lead and formaldehyde," said Alexander-Scott.
"E-cigs have propylene glycol and some have ethylene glycol. These are compounds that in large enough doses can be toxic," said Jamieson.
"They're not regulated, so we're not able to tell how many of the other additives that are there are there," said Alexander-Scott.
Because there are no quality controls, research is so important to figure out what's not known.
"It's not known how chronic exposure to these chemicals is going to affect the ability of the lung to function and the lung cells to survive," said Jamieson.
And until they're regulated, Alexander-Scott warns: "These are not safe. This is not a mechanism to try to quit smoking."
If you're trying to quit smoking or e-cigarette vaping you can call this number: 1-800-QUIT-NOW.