30 January 2025
There is a widespread consensus that E-cigarettes (ECs) provide smokers with a much safer nicotine delivery than combustible cigarettes, thus motivating part of the global public health community to endorse their adoption by smokers as a popular harm reduction product to substitute conventional tobacco cigarettes (CCs)[1][2] (see the opposing stance to this policy in[3]). While users of the devices (“vapers”) are exposed to significantly less harmful and potentially harmful compounds (HPHCs), it is still necessary to assess the risks involved in their usage. This is a complex process involving laboratory testing of EC emissions followed by probing the biological and medical effects of the inhaled chemicals through preclinical studies (biomarkers, cytotoxicity, animal models) and clinical studies. In particular, in vitro and in vivo studies (in spite of their known limitations[2][4][5][6][7][8][9][10][11]), might provide a valuable laboratory evaluation of toxicity from exposure to EC aerosol emissions, contributing to the assessment of the safety profile of ECs.