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Figure 1 Materials and methods A search of scientific literature was conducted using the PubMed database ( The following Medical Subject Headings (MeSH) terms were used: e-cigarettes AND flavor AND nicotine AND e-liquid AND cytotoxicity AND cellular damage and health AND adolescent AND young people. We included publications from 2020 to 2025 because fourth-generation electronic cigarettes appeared on the market in 2020 ( in vitro studies, in silico models, and studies using cannabis cigarettes or tobacco flavors, hookahs, nicotine pouches, and waterpipes

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Other nicotine replacement products eliminate inhalation from the delivery which should work efficiently for reducing harm, however the success rates aren't as good when compared to vaping, so the question is: do E-Cigarettes count as harm reduction

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