The case-based discussion of an adult smoker with respiratory symptoms and worsened pulmonary function shortly after switching to an electronic cigarette (e-cig) can be interpreted differently.

Ironically, some people experience transient (days/weeks) worsening of respiratory symptoms (cough, wheezing, chest tightness) after quitting.

Cough and breathlessness have been reported when switching to e-cigs, but progressive improvement in respiratory symptoms is usually observed with regular use of these products.

Significant risk reduction and harm reversal are expected in smokers who switch from tobacco to e-cigs. Signs and symptoms compatible with contact dermatitis around the mouth or in the oral mucosa may occur in predisposed e-cig users exposed to propylene glycol (PG) in the vapour, but the e-liquid used by this patient contained glycerol, not PG. Hypersensitivity response to glycerol has never been reported to our knowledge. Consequently, performing...