In the last ten years, many adults, young and old, have started to use electronic cigarettes as an alternative to tobacco cigarettes. At first, inhaling vapor in this manner was thought to be less harmful than smoking. However, e-cigarettes are still unregulated by the FDA which means that users ultimately have no idea what they are truly inhaling. At this time, medical evidence exists to suggest that e-cigarettes are unsafe. The American Lung Association and many oncologists suggest caution in using e-cigarettes.

E-cigarettes utilize a battery to provide a heating element to heat liquid from a cartridge, releasing a vapor consisting of nicotine, propylene glycol, and other numerous and unknown chemicals. Because there is no government oversight and regulation of approximately 500 brands and over 7,000 flavors of e-cigarettes currently on the market, it is impossible to know the exact chemical composition of any e-cigarette, and obviously the short-term and long- term effects of its ingredients.

Currently, there is little or no evidence suggesting that e-cigarettes are safe. The American Lung Association has requested that the FDA assume regulatory oversight of e-cigarettes, as they do with tobacco cigarettes. This would include required warning labels, disclosure of ingredients, and restrictions on access by minors. It is interesting that recent generations have heeded the warnings of anti-smoking propaganda in the last quarter-century and stayed away from tobacco cigarettes, only to now use e-cigarettes at significant rates.

Based upon a study released in 2014, some oncologists state that such devices are of unknown safety and benefit. They further recommend smokers act with precaution and try to stop smoking rather than begin use of e-cigarettes because of an assumption they are a safe alternative. A study by the University of North Carolina suggests that e-cigarettes may affect and alter a multitude of genes important for immune defense in certain cells in the respiratory tract, which likely increases the risk of bacterial infections, viruses, and inflammation. An article in the New England Journal of Medicine published in January of 2015, states that ECs are significantly dangerous based upon the amounts of hidden formaldehyde.