E-cigarettes are controversial, but some doctors warn that they are not a good alternative to smoking conventional cigarettes, reports the Roanoke Rapids Daily Herald.

E-cigarettes use a heating element to warm and vaporize a liquid that contains flavorings and nicotine. They give smokers the physical sensation of smoking without the harmful smoke.

While little is known about the long-term effects of the chemicals found in e-cigarettes, the presence of nicotine concerns many doctors. Nicotine, a substance found in tobacco, elevates a smoker’s mood and suppresses the appetite. The stimulant is also as “addictive as heroin,” Carter says.

Nicotine is known to damage blood vessels and lead to heart disease, Carter says. A 2013 study found that nicotine chewed through cells found in the heart and led to atherosclerosis — plaque that builds up in arteries.

“The patients that are at risk for heart attacks or strokes or cardiovascular disease, that is still a huge factor when nicotine is being consumed,” Carter says.

The amount of nicotine consumed in an e-cigarette is difficult to understand, Carter says.

“How much you actually use it, how heated the element is, how long you inhale for — those are the variables in vaping,” she says.

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