Future research should be extended to further investigate the effects of e-smoking as a possible risk factor for the development of chronic respiratory diseases.
Due to the fact that e-cigarettes have only been in the market for a decade, studies on the long term effects of e-smoking on health are not available.
Echocardiography showed no effect of e-smoking on heart function while smoking a tobacco cigarette resulted in delayed relaxation of left ventricular (LV) .
Another study also showed that after e-smoking, fractional exhaled nitric oxide (FeNO) level increased for 7 out of 9 cases .
Motivation to start e-smoking was to quit or reduce smoking tobacco, the possibility to use in public places, health considerations, and financial concerns [1,54-57].
A similar position has been agreed upon as the Forum of International Respiratory Societies (FIRS), which indicates that until clear data on the safety and health impact of e-smoking is available, e-cigarettes should be restricted or banned .
The European Union in the Tobacco Products Directive (2014/40/EU) indicates that e-smoking is a major public health problem because e-cigarettes simulate smoking behavior and social approval for smoking .
Findings provided by human studies show the short-term impact of e-smoking on health and the convincing data points to such disorders as changes in lung function (e.g., increase in lung impedance, peripheral airway flow resistance) and involvement of the mechanism of oxidative stress.
Australia, Canada, Mexico, Russia, Brazil, Lebanon, the UAE, Israel, Norway, Panama, Hong Kong, Thailand and Singapore have banned e-smoking