At least seven stores specializing in electronic cigarettes have opened this year in the Madison area, selling what operators and some anti-tobacco advocates say are a safer alternative to regular cigarettes.

But health officials say little is known about the health effects of e-cigarettes, battery-powered devices that vaporize liquid nicotine. They worry that many of the flavors available, including sugar cookie and bubble gum, are luring non-smoking youth, who might transition to regular smoking.

Wisconsin bans sales of any nicotine products to minors, but the state’s indoor smoking ban doesn’t apply to e-cigarettes — leaving employers and municipalities to decide if they want to prohibit them.

With big tobacco companies getting into the e-cigarette business and the federal Food and Drug Administration preparing regulations, the debate over the devices continues to heat up.

“E-cigs made it unbelievably easy for me to quit smoking,” said Chris Mansavage, 31, of Madison, as he puffed on a cinnamon toast crunch e-cigarette at Huffle Puff Vapes on Madison’s East Side.

“We are in this business to help people quit smoking and to improve their health,” says the website for the store, which sells more than 100 flavors of e-cigarettes, from bacon and blueberry to Snickers bar.

Dona Wininsky, spokeswoman for the American Lung Association in Wisconsin, said it’s not clear what chemicals are in some e-cigarettes. The devices don’t have the tar and carbon monoxide of regular cigarettes, but that doesn’t mean they are safe, she said.

“Short of inhaling the exhaust from your tailpipe, virtually nothing is as bad as regular cigarette smoke,” Wininsky said. “But until we have a more solid body of science as to what is in e-cigarette vapor, anybody is taking a risk to use them or be in the same room.”

Nicotine poisonings increase

Liquid nicotine is potentially dangerous if ingested or absorbed through the skin. Poison centers reported 2,313 exposures to e-cigarettes or liquid nicotine this year through the end of July, according to the American Association of Poison Control Centers. That’s up from 1,414 exposures for all of last year, more than half of them in children under age 6.

Wisconsin had 14 such calls in a recent 12-month period, seven in children under 6, according to the Wisconsin Poison Center.

The Minneapolis-based Pet Poison Helpline said this month that e-cigarette-related nicotine poisoning calls for pets doubled in the past six months.

People who smoke should try proven cessation tools such as medications and nicotine patches and gums, the American Lung Association and the American Heart Association say.

Still, “it’s a no-brainer” that smokers who switch to e-cigarettes are reducing harm, said Doug Jorenby, clinical services director at UW-Madison’s Center for Tobacco Research and Intervention. “Based on what we know at the moment, it’s almost beyond debate,” he said.

The center conducted an FDA-funded study over the past year comparing people’s experiences with e-cigarettes and regular cigarettes. Results of the study, involving 150 smokers in Madison and Milwaukee, should be available soon.

Jorenby said some people who try to switch from regular cigarettes to e-cigarettes end up using both, which may not reduce harm.

A Centers for Disease Control and Prevention study last month said an estimated 263,000 middle school and high school students who never smoked cigarettes used e-cigarettes in 2013, up from 79,000 in 2011. Non-smoking youth who tried e-cigarettes were twice as likely as those who didn’t to say they intended to smoke regular cigarettes within the next year.

With thousands of flavors available, “it really does seem like this may be aimed at a younger demographic,” Jorenby said.

More stores selling e-cigarettes

At Huffle Puff Vapors, on Milwaukee Street, owner Kevin DeBauch said he checks customers’ identification and doesn’t sell to minors. He and operators of other e-cigarette stores say they use four ingredients: nicotine, vegetable glycerin, propylene glycol and artificial or natural flavoring.

E-cigarette, or vaping, devices cost $15 to $400 or more with vials of liquid nicotine available from $8 to $169 based on volume, DeBauch said. Users can choose among four standard concentrations of nicotine.

The vapor produced looks and smells like fog machines found in nightclubs or haunted houses.

Mansavage said he started with a concentration of 18 milligrams of nicotine then shifted to 12 mg and plans to try 8 mg soon. An $8 bottle lasts him two weeks.

With e-cigarettes, “I feel like I’m in control of my quitting,” he said.

Since Huffle Puff Vapors opened in January, four other stores specializing in e-cigarettes have opened in Madison: Mad Vapor, Puff Vapor and two Infinite Vapor locations. Also, Midwest Vapors opened in Monona and Madtown Vapor opened in Cambridge.

In addition, some tobacco products stores — such as Azara, Knuckleheads and Smokes on State, all on State Street — started selling e-cigarettes in the past year or two.

Smaller e-cigarette devices, sometimes called “cigalikes,” are becoming widely available in convenience stores, with some produced by the tobacco companies Altria Group, Reynolds American and Lorillard.

Wisconsin’s indoor smoking ban, which in 2010 prohibited smoking in bars, restaurants, private clubs, schools, hotels, clinics and other workplaces, doesn’t apply to e-cigarettes or vaping, said Jennifer Miller, spokeswoman for the state Department of Health Services.

Ashwaubenon and Onalaska added e-cigarettes to their indoor smoking ordinances this year, and Eau Claire banned e-cigarettes on city and county properties, said Sara Sahli with the Wisconsin chapter of the American Cancer Society Cancer Action Network.

Nationally, dozens of cities including Boston, Chicago, Los Angeles and New York have restricted e-cigarettes in smokefree areas, according to the American Nonsmokers’ Rights Foundation in Berkeley, California.

FDA considering e-cigarette regulations

The state of Wisconsin and UW Health are among Madison-area employers that have added e-cigarettes to their smoking bans, spokespeople said. The Madison School District plans to add them to its policy this year. UW-Madison allows e-cigarettes but plans to re-evaluate the issue this year.

Most bars and taverns permit e-cigarettes and vaping, said Pete Madland, executive director of the Tavern League of Wisconsin.

A bill by state Sen. Glenn Grothman, R-West Bend, to state explicitly that the state’s smoking ban doesn’t apply to e-cigarettes failed to pass this spring.

In April, the FDA proposed regulating e-cigarettes as tobacco products, banning sales to minors and requiring warning labels. The agency could also restrict flavors and advertising, among other moves.

The FDA accepted public comments through last month. It’s not clear when it might issue final regulations.

Forty attorneys general asked last year for FDA regulations on e-cigarettes, and this year 29 attorneys general called for stricter rules than the agency proposed. Wisconsin Attorney General J.B. Van Hollen was not among either group.

Operators of e-cigarette stores say federal regulations could legitimize their industry but might also involve costly testing and paperwork that could give big tobacco companies an edge.

“We need to make sure the people who do these things are doing them in viable labs,” said Dawn Gundermann, co-owner of Puff Vapor, on East Johnson Street.

But, said Jason Clark, owner of Smokes on State, “it could knock out the little niche markets that have helped people switch from cigarettes to vaping.”

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David Wahlberg is the health and medicine reporter for the Wisconsin State Journal.