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Type of tobacco products In recent years, non-combustible forms of nicotine/ tobacco use, such as electronic cigarettes (e-cigarettes) and heated tobacco products (HTPs), have been introduced as potentially less-risky alternatives to traditional combusted tobacco products, including classic cigarettes

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Dual users had a 1.9-times higher odds of developing respiratory symptoms compared with exclusive e-cigarette users and a 1.24-times higher odds compared with exclusive tobacco smokers

The rise in vaping among young people and the widespread availability of alternative nicotine products indicate a shift in nicotine use patterns, which could maintain the exposure of younger generations to nicotine addiction and even increase the risk of relapse into smoking, assuming the hypothesis of a gateway effect of these products is confirmed