The Food and Drug Administration (FDA) is notifying the public that cases of seizures have been reported following the use of e-cigarettes.

Seizures have previously been linked with nicotine poisoning and have been reported in the literature following ingestion of nicotine e-liquids. An FDA review of voluntary adverse event reports of these products found 35 cases of seizures following the use of e-cigarettes between 2010 to early 2019.

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“We want to be clear that we don’t know yet if there’s a direct relationship between the use of e-cigs and a risk of seizure,” said FDA Commissioner Scott Gottlieb, in an appearance before the House Appropriations Subcommittee.

Most of the reports received do not provide enough information to make clear connections between the products and seizures; there is no mention of specific brands of e-cigarettes, and in some cases, the seizures occurred when other substances (marijuana, amphetamines) were being used. In some of the reports, users mentioned a prior history of seizure diagnosis.

To help gather more information, the FDA is asking the public to report unexpected health or product issues to the Safety Reporting Portal. “We need more information before we can determine if there’s in fact a link between e-cigarette use and the reported incidents,” said Gottlieb. “It’s our hope that these public steps to solicit additional reports of adverse events, along with other agency efforts, will allow us to understand whether there’s a connection.”

Enforcing higher standards on marketing and age verification for e-cigarettes has been one of Gottlieb’s top priorities during his last 2 years at the agency (he is due to step down as FDA Commissioner this month). The agency acknowledged that for adults, e-cigarettes may be considered an “off-ramp” from combustible cigarettes to a less harmful form, but they stated, “We’ve also been clear that, even for adults, e-cigarettes are not risk free.”

For more information visit FDA.gov.

This article originally appeared on MPR