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Starting to use e-cigarettes or switching from tobacco products to e-cigarettes increases your risk of adverse health effects. Interestingly, there is a strong difference of opinion on e-cigarettes between countries. Whereas countries such as Brazil, Uruguay and India have banned the sale of e-cigarettes, others such as the United Kingdom support this device to quit smoking.

Of note, the abstinence rate found in the nicotine-replacement group was lower than what is usually expected with this therapy. Nevertheless, the incidence of throat and mouth irritation was higher in the e-cigarette group than in the nicotine-replacement group (65.3% vs. 51.2%, respectively). Also, the participant adherence to the treatment after 1-year abstinence was significantly higher in the e-cigarette group (80%) than in nicotine-replacement products group (9%) [100]. These data overall indicate that the harmful effects of nicotine should not be underestimated. Despite the established regulations, some inaccuracies in nicotine content labelling remain in different brands of e-liquids.

The Policy Scan Project, by the Institute for Global Tobacco Control (at Johns Hopkins University) tracks and reports regulatory approaches to e-cigarettes around the world. In 2012 and 2013 there was a flurry of tobacco company investment in e-cigarettes, both in the United Kingdom (UK) and in the United States (US), a trend which continued in subsequent years. In 2018, 8% of Pierce County 12th&nbsp