Electronic cigarettes are often advertised as substitutes and alternatives to tobacco or as smoking cessation devices. The practice of inhaling the vapor from the electronic cigarette provides not only the nicotine that the body that has developed addiction feels the need for, but also a tactile, olfactory and gustatory experience that recalls that of the cigarette. The various marketing strategies relating to the electronic cigarette focus on several points: For smokers who do not intend to stop smoking tobacco, the electronic cigarette represents a way to be able to “smoke” even in environments where there is a ban on conventional smoking, such as airplanes, restaurants and workplaces. For smokers who don’t want to give up their nicotine addiction, some studies suggest that switching to e-cigarettes reduces the potential harm attributable to their habit. For people who want to quit, some suggest that e-cigarettes can help with the transition from smokers to non-smokers. However, any health benefits associated with these claims are based on inaccurate, incomplete or misleading information. Since July 2013, the World Health Organization has taken a stand on the matter, stating that no rigorous studies have yet been conducted to determine whether e-cigarettes are actually effective in helping people quit smoking. In August 2014, the World Health Organization called on governments to ban the sale of e-cigarettes to minors, warning that vulnerable categories to the effects of their use are children and adolescents, pregnant women (for the fetus) and in reproductive age. In addition, the Food and Drug Administration (FDA) questioned the safety of these products after detecting different amounts of nicotine than stated, and traces of toxic chemicals including known carcinogenic components (such as nitrosamines) in samples from two very popular brands. This prompted the FDA to issue a warning about the potential health risks associated with e-cigarettes. When e-cigarettes are used as smoking cessation aids, they are intended to deliver inhaled nicotine directly to the lungs. However, none of the other regulated and recognized smoking cessation products, such as nicotine patches and chewing gum, deliver it by other routes of administration. Furthermore, the biological mechanism by which smoking cessation can be achieved using the e-cigarette remains to be defined with certainty. Added to this is the consideration that, even though the artificial “smoke” of e-cigarettes appears to contain fewer toxins than those present in traditional cigarette smoke, the long-term health impact still needs to be explored. Additionally, these products contain no health warnings comparable to FDA-approved nicotine replacement products or conventional cigarettes. Healthcare professionals are encouraged to recommend conventional nicotine replacement therapies, but for patients unwilling to use or continue with such methods, they could present e-cigarettes as an option to curb smoking. Issues discussed in the scientific community in summary On the one hand, the electronic cigarette is a less harmful alternative to traditional cigarettes and represents a support for those who intend to quit smoking. On the other hand, it cannot be said that it is harmless or less toxic, due to the presence of some dangerous substances, such as heavy metals and aldehydes in the vapour. The harms of smoking are known to emerge over a period of several years. This means that in order to evaluate the health impact of e-cigarettes versus traditional smoking in the clinical setting, long-term epidemiological studies are needed. To date, the scarcity of information on their effects after years of use, as well as the widespread trend among young people, who risk becoming addicted by vaping nicotine, have recently prompted the WHO to define them harmful to health and should therefore be subject to regulation (report “Who Report on the Global Tobacco Epidemic”, 2019). Are e-cigarettes bad for you? What is important to know In the absence of certain data on the efficacy and safety of electronic cigarettes, until medium and long-term independent studies are carried out, it will not be possible to take a clear position on its effects on health. Meanwhile, as a precaution, e-cigarettes should at least be avoided by young people and pregnant women. Also, it is always good to remember that the most important risk factor for LUNG CANCER is represented by cigarette smoke (and this also applies to passive smoking). This means that the more you have smoked (or the more smoke you have breathed in your life), the more likely you are to get sick. In 2019, the Ministry of Health estimated 42,500 new diagnoses of lung cancer, which still remains the most frequent cause of death from cancer nationwide, followed by colorectal, breast, pancreatic and liver cancer. In 2016, 33,838 deaths from lung cancer were recorded (ISTAT data).

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