National data indicate that water pipe smoking in the British general population is very low, at around 1%
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[51] A 2014 in vitro study demonstrated that e-cigarette use of a "balsamic" flavor with no nicotine can activate the release of proinflammatory cytokine in lung epithelial cells and keratinocytes
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In Canada, 3 pharmacotherapies (bupropion, nicotine replacement therapy [NRT], varenicline) are approved for smoking cessation,15 , 16 with others available as approved natural health products (e.g., cytisine).16 E-cigarettes (also referred to as vaporizers, vapes, or electronic nicotine delivery systems) might also help users quit tobacco smoking or reduce harms of smoking if a person switches from cigarettes to e-cigarettes.17 No e-cigarette products, however, have been approved for smoking cessation in Canada.18 Preferences for smoking cessation interventions vary, and people may attempt to quit multiple times with different interventions or combinations of interventions before being successful.19 This guideline provides a menu of evidence-based interventions that can be provided or referred to by practitioners to help adults choose options that are accessible to them and best fit with their values and preferences