Role of E-Cigarettes in Smoking Cessation: Friend or Foe? an Investigation of Safety, Efficacy, and Controversies in Pakistan

Electronic cigarettes have become quite popular as an adjunct to smoking cessation, although their effectiveness remains the subject of much speculation, as e-cigarettes deliver nicotine without the injurious byproducts of burning tobacco.This research aims to establish the effectiveness, the applicability or the concerns with the use of e-cigarettes in smoking cessation project in Pakistan.Data were gathered employing a cross-sectional approach from 600 participants from the large-scale cities, such as Islamabad, Karachi, Lahore, and Faisalabad, during January 2023-December 2023.Participants were divided into three groups: 200 current smokers in the control group receiving standard cessation techniques, 200 participants using e-cigarettes in the intervention group, and 200 participants who have quit smoking in the past using any technique.Safety was evaluated by respiratory and cardiovascular clinical and biochemical markers; efficacy through participant self-reports and biochemical validation by a CO monitor.Moreover, semistructured interviews were also carried out to identify societal considera-tion, regulation and health issues with e-cigarette use.The study showed that the e-cigarette group had a better smoking cessation rate of 65% as compared to the control group of 45% and also the CO level differences being statistically significant (p< 0.01).But the composite safety assessment of the e-cigarette group indicated that respiratory biomarkers demonstrate higher levels than those of the control group depends on features and long-term respiratory health impacts.Some key qualitative results showed combined societal opinions, regulatory inabilities, and concerns related to addictive behavior.This present work therefore depicts the bipartite perspective of e-cigarettes in smoking cessation within the context of Pakistan, therefore calls for the introduction of proper policies and awareness regarding the utility of e-cigarettes for the benefits they bring, while at the same time informing society of the possible negative impacts it has and controversies surrounding it.