Many people who have experienced e-cigarette or “vaping” explosions return to smoking traditional cigarettes as a way to cope with the stress of serious injury, according to a speaker at a Food and Drug Administration workshop held Wednesday.

Dr. Felicia Williams, a surgeon at the University of North Carolina’s Jaycee Burn Center, told attendees that e-cigarette explosions typically require surgery and numerous therapies, and can leave the victim permanently disabled.

Williams — who was on a panel to discuss the instability of e-cigarette batteries — showed graphic photos of explosion victims, including a 30-year-old man whose device exploded in his pocket while he was driving. The man lost his eye and suffered severe thermal burns.

The panel noted that explosions are rare, but reports of e-cigarette explosions have been increasing along with the devices’ popularity.

A U.S. Fire Administration survey found 195 incidents of explosions between January 2009 and December of last year, with 135 resulting in acute injuries.

The survey found that while the number of explosions is statistically uncommon, the number of acute injuries has increased over the past several years.

No explosions have resulted in mass casualty events, but Williams said that risk exists as long as the devices remain unpredictable.

Explosions most often occur because the atomizer, an attached heating source, heats too rapidly, expands and then ejects the device’s core, said panelist Lawrence McKenna Jr. of the USFA.

The majority of e-cigarette explosions occur while the device is in the victim’s pocket or while in use. Most explosions result in surgery because the closeness can result in “devastating” injuries, he said. Less than 1 percent of explosions occur while the device is charging.

There are currently more than 500 brands of e-cigarettes marketed in the U.S. with such flavorings as candy, fruit and alcohol, according to Williams.

E-cigarettes have been marketed by some retailers as smoking cessation tools, and they have become increasingly popular, especially among teens. A 2015 survey found that 16 percent of high school students used e-cigarettes during the past month.

The FDA recommends some safety steps, which include: using e-cigarettes that offer safety features; keeping e-cigarettes covered; never using a phone or tablet charger with an e-cigarette; do not charge an e-cigarette overnight; replace batteries if they get damaged or wet.