When e-cigarettes were introduced in the U.S. in the mid-2000s, many people saw them as a tool to help smokers quit.

They sounded great — none of the tar and some other chemicals found in traditional cigarettes would be inhaled, but smokers could get their nicotine fix. And most studies showed they did help smokers cut back or quit.

But the question now is at what cost?

A dozen New Yorkers — and nearly 200 people across the nation — have been hospitalized for severe pulmonary disease in recent weeks after using nicotine or marijuana vaping products. One person in Illinois has died.

Officials said they don’t know whether the illnesses are associated with the vaping devices or with the ingredients or contaminants inhaled through them. Health officials have said patients have described using several substances, including nicotine, marijuana-based products and “home brews.”

Why the recent surge of illnesses is taking place now when the devices have been readily available for more than a decade is unknown. Brian King, deputy director for research translation for the CDC’s Office on Smoking and Health, told The Washington Post cases could have been occurring previously, “but we weren’t necessarily capturing them.”

Because of the dozen illnesses in New York, state officials have declared an emergency health threat and launched an inquiry.

The suspected connection between lung disease and vaping warrants that a study be conducted into the long-term health effects from vaping, said Dr. Howard Zucker, the state health commissioner.

“While many people consider vaping to be a less dangerous alternative to smoking cigarettes, it is not risk free,” Zucker said.

There are few long-term studies into vaping. And there are variables involved: the method of delivery (what type and brand of vape or e-cigarette is used) and what products are being used with the vape. Do the combinations make a difference?

Mitch Zeller, who heads the Center for Tobacco Products at the Food and Drug Administration, told the Washington Post the agency is working to identify what products were used by the sickened patients, where they were purchased, how they were used and whether other compounds were added. “That information needs to be strung together for every single one of these cases to see if any patterns emerge,” he said.

The state Health Department said it is sending information from its study to the Centers for Disease Control as well as health officials in other states responding to similar vape-related hospitalizations.

The state’s advisory, issued to administrators of health care clinics and hospitals, states: “Providers should remain alert for potential cases among patients who present with progressive respiratory symptoms, especially in those without a history of respiratory illness.”

It goes on to recommend that providers acquire from patients “a thorough substance use history,” with close attention to inhalation drug use, “particularly vape products.”

The New York study includes sending samples of the vaping products used by the ailing patients to the Wadsworth Center Laboratory near Albany for testing.

While the number of smokers is declining, vaping is on the rise — especially among young adults.

Just like cigarettes were advertised as beneficial when they were introduced, and the dangers unknown or downplayed, the same could be true now about vaping.

Is vaping better for your health than smoking? Maybe. But right now, no one really knows. The safest bet is to not start — or continue — either one.

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