Lori Vish-Stearns, executive director of Community Health Challenge of Southwestern Pennsylvania, shows an electronic cigarette, or e-cigarette, at the agency's office in Adams Township. Vish-Stearns fears the devices, which are gaining in popularity among smokers, also are being used by children and teens.

The use of electronic cigarettes, or e-cigarettes, has been going up.

The devices were introduced in 2006 and national sales have been estimated to reach nearly $2 billion in 2013.

Dale Schreffler, owner of Cal's General Store in Portersville, said that sales have increased during the past few years.

“It seems to be getting more and more (popular),” Schreffler said.

They are powered by battery and they heat a liquid containing nicotine. The liquid, which can be flavored, creates a vapor that users inhale as they would smoke.

Schreffler said the store sells three or four kinds.

“They're all still trying to figure out which ones they like,” he said.

Lori Vish-Stearns, executive director of Community Health Challenge of Southwestern Pennsylvania in Adams Township, which offers stop smoking programs among others, said that the use of these devices is increasing, particularly by middle school aged youth.

“We're highly concerned about that,” Vish-Stearns said.

The Food and Drug Administration recently announced a proposal to ban the sale of electronic cigarettes to minors.

Last year, state Sen. Tim Solobay, D-46th, introduced a bill that would ban the sale of the devices to children under 18 in Pennsylvania. At the time, Solobay noted that 28 states have banned the sale of electronic cigarettes to minors.

Vish-Stearns said nicotine is detrimental to the development of the adolescent brain, permanently changing the part of the brain that regulates pleasure and rewards.

“It makes it difficult to stop the addiction,” Vish-Stearns said, noting it also makes them more prone to developing other chemical dependencies.

She said long-term side effects of nicotine use include high blood pressure and an increase in blood sugar instability, which can lead to developing diabetes or causing problems for diabetics.

“Nicotine is not harmless,” Vish-Stearns said.

Vish-Stearns said any of the tobacco prevention programs her group offers can apply to electronic cigarettes, but she said no one specifically has asked about programs to stop using the devices.“I think that is interesting,” Vish-Stearns said.Supporters of e-cigarettes say they can help people quit smoking. Beyond that, they say it does not involve the health risks posed by smoke from burning tobacco, which contains tars and other chemicals that cause cancer.Although there are studies that back up the effectiveness of using nicotine gum and patches to quit smoking, Vish-Stearns said there have not been a lot of studies on the use of electronic cigarettes being used to quit.Beth Neveux, prevention specialist with the Butler County drug and alcohol program, said electronic cigarettes are included in the program's tobacco education.She said the marketing is the same as other tobacco products, and the devices have flavors that are palatable to kids. She said the program is trying to educate youth and parents on the packaging.Neveux noted that an electronic cigarette looks like a pen.“You really can't tell the difference,” Neveux said.Health studies still are being done, and she said some studies have shown the vapors contain hazardous chemicals.Although some consider e-cigarettes to be devices used to quit smoking, Neveux said the level of nicotine makes them unrealistic to use as smoking cessation products.“It truly is a high level of nicotine,” Neveux said.Information about programs offered by the Community Health Challenge is available online at www.communityhealthchallenge.org.

Sales of electronic cigarettes, or e-cigarettes, are on the rise. The battery-powered devices create a nicotine vapor that can be inhaled.