Sheila Brewers smoked for 48 years, making it an extremely hard habit to break.

"I've tried so many times. I even accomplished three months, and I never stopped wanting a cigarette," Brewers said.

That was until she tried electronic cigarettes. Brewers started using e-cigarettes two years ago and has been smoke-free ever since.

"I feel so much better,'' said Brewers, of Montgomery, Minn. "I can breathe so much better. Everything is so much better."

Brewers attributes her elation to e-cigs, which vaporize liquid through a small battery-powered heating element, which the smoker then inhales. The liquid solutions come in a wide variety of flavors and nicotine concentrations. Some solutions have nicotine levels that are slightly stronger than a standard cigarette, while others have no nicotine at all. It looks and feels like you're smoking a cigarette, but you're not really.

For that reason, some retailers are promoting e-cigs as an effective (and even cool) smoking cessation tool. Health and regulatory officials caution that there have been no independent studies on the safety of the devices. Despite that, use of the faux cigarettes seems to be catching on.

A Chinese pharmacist developed the patent for e-cig technology in 2003. Four years later they landed here and have been growing in popularity since. The percent of U.S. adults who have tried an e-cig more than quadrupled in a year's time, from six-tenths of 1 percent in 2009 to 2.7 percent in 2010, according to the U.S. Centers for Disease Control and Prevention.

Minnesota-based e-cigarette retailer Jesse Griffith, who owns Smokeless Smoking, said he's seen similar growth locally. "We were tracking selling 500 refill bottles [in December] and we went up to 600 in January," he said. In the past year, Griffith's shop has expanded from its original location in Burnsville Center to the Maplewood Mall and Rosedale.

Personal preference

According to Griffith, each customer responds differently to the e-cigs, especially if they are using them to stop smoking. Like Brewers, Steve Lyzenga of Rosemount went to Smokeless Smoking to quit conventional cigarettes. "I had gone both smoke- and nicotine-free," Lyzenga wrote in an e-mail. "I was probably four or so months deep using a zero-nicotine load in pomegranate flavor, so it was purely just going through motion of smoking at that point."

But it didn't stick. Lyzenga has started smoking again, but plans to return to e-cigs soon.

Griffith talks to customers about their smoking habits and preferences. He then tries to set them up with a package that has flavor and nicotine levels similar to the conventional cigarettes they smoke.

"Generally, if they are a pack-a-day full-flavor, then we're going to set them up with something that's probably going to cost them a little bit shy of $100," Griffith said. "That's going to be the equipment and that's also going to be about a month's worth of refills for them." Griffith estimates that e-cigs cost average smokers 20 percent of what they spend on regular cigarettes.

Just another addiction?

As e-cigarette sales grow, so does attention from the medical community. There are almost no independent studies on e-cigs, which leaves a lot of unanswered questions.

"Is this being brought to market as a way of introducing kids or young adults to nicotine addiction? Is it really a nicotine addiction device? ... We don't know," said Dr. Thomas Kottke, a HealthPartners cardiologist.

Griffith tries to avoid selling to nonsmokers, seeking instead to give conventional smokers a healthier alternative. "We do feel that we have somewhat of a social responsibility to not get people addicted to nicotine," Griffith said. "We want them to have the better of two evils, not the worse of two evils."

The federal Food and Drug Administration (FDA) has attempted to step in. The U.S. District Court of Appeals in Washington, D.C., however, ruled that e-cigarettes and other tobacco-containing products are not drugs unless they are marketed specifically for therapeutic purposes, barring the FDA from interfering.

For Kottke, more studies would provide data as to whether e-cigs are a safe alternative to regular cigarettes. "Before we say this is an effective tool ... for helping people quit, we actually need some evidence," Kottke said.

According to Kottke, since an e-cig is inhaled, it is a better way of delivering nicotine than a device that enters the bloodstream. "It gives you an instant hit. It's like you're snorting a drug. It's inhaling a drug ... and that's always been the problem with things like nicotine patches and nicotine gum,'' he said, adding that what's unclear is whether e-cigs keep smokers off regular cigarettes or enable smoking habits.

The effectiveness of e-cigs as a way to help smokers quit is not the only issue. Many experts wonder if e-cig technology and liquid nicotine solutions are safe, a concern reinforced recently when a Florida man was severely injured after an electronic smoking device exploded in his mouth.

Griffith is in favor of more studies and a measure of quality control to help determine which are the safest and highest-quality products.

Peter Funk is a University of Minnesota student reporter on assignment for the Star Tribune.