The Food and Drug Administration last week threatened a ban on flavored e-cigarettes after research showed the number of teens using the devices has reached epidemic proportions.

“I’ve been asked a lot of questions about electronic cigarettes in my community nurse travels,” says Lisa Hageman, a nurse at Backus Hospital. “The topic made The New York Times last year after New York Gov. Andrew Cuomo authorized a ban of e-cigarettes in public indoor spaces in New York State, just like real cigarettes.

Electronic or e-cigarettes, e-pens, e-pipes, e-hookah and e-cigars are known collectively as ENDS, or electronic nicotine delivery systems. According to the FDA, e-cigarettes allow users to inhale, or vape, an aerosol containing nicotine or other substances. They are generally battery-operated and heat e-liquid from a refillable cartridge, releasing the aerosol.

There has been a significant increase in e-cigarette use in recent years, particularly among children, teens and smokers looking for an alternative to traditional cigarettes. On Sept. 12, the FDA sent warning letters to 1,300 e-cigarette retailers and manufacturers after an undercover investigation found that many were selling illegally to minors.

The FDA also gave five manufacturers 60 days to submit plans proving they can keep their product out of the hands of minors. If they cannot, they may be required to stop selling some or all of their flavored products, which are particularly popular with teens.

Hageman offers myths and facts about e-cigarettes.

MYTH: E-cigarettes are safe.

FACT:  E-cigarettes are tobacco products. The U.S. Surgeon General concluded that e-cigarettes can expose users to several potentially harmful chemicals, including nicotine, carbonyl compounds and volatile organic compounds. With nearly 500 brands and 7,700 flavorings on the market, there are few ways for anyone other than the manufacturers to know exactly what chemicals are in e-liquids.

MYTH: E-cigarettes don’t have nicotine.

FACT: Almost all e-cigarettes contain nicotine, including many that claim they are nicotine-free. A 2014 study showed wide-ranging nicotine levels in e-cigarettes and inconsistencies between listed and actual nicotine levels. Nicotine is an addictive substance that can have negative health impacts, including on adolescent brain development. The more nicotine a person uses, the greater the potential for addiction.

MYTH: E-cigarettes can help smokers quit.

FACT: The FDA hasn’t found any e-cigarette to safely and effectively help smokers quit. Instead of quitting, many e-cigarette users continue to use e-cigarettes and conventional cigarettes. In 2015, 59 percent of the people who recently used e-cigarettes also smoked conventional cigarettes.

MYTH: E-cigarettes aren’t marketed to kids.

FACT: E-cigarette use among middle and high school students more than tripled from 2013 to 2015. With aggressive marketing tactics, including the use of cartoon characters and such flavors as bubblegum, chocolate and strawberry, it’s no surprise studies show a dramatic increase in kids using e-cigarettes. Between 2011 and 2015, the U.S. Surgeon General found e-cigarette use among high school students increased by 900 percent with more teens now using e-cigarettes than cigarettes. Nicotine exposure during adolescence can cause addiction and can harm the developing brain. Young people who use e-cigarettes and other tobacco products are uniquely at risk for the long-term, long-lasting effects of exposing their developing brains to nicotine.

MYTH: There’s no secondhand emission from e-cigarettes.

FACT: E-cigarettes expose others to secondhand emissions. The aerosol (vapor) emitted by e-cigarettes and exhaled by users contains carcinogens (cancer causing) such as formaldehyde, according to early studies. Little is known about these emissions or the potential harm they can cause.

For information on smoking cessation classes at Hartford HealthCare, click here.