Electronic cigarettes (e-cigs), also known as electronic nicotine delivery systems, have gained popularity as an alternative to conventional tobacco smoking. Despite being initially promoted as safer alternatives, mounting evidence suggests that there are potential health risks associated with their use. This chapter discusses the diverse range of health concerns linked to e-cig use, including respiratory diseases, cardiovascular morbidity, and increased cancer risk. Additionally, it explores the current landscape of e-cig use, highlighting trends among different age groups and regions. While some studies have suggested potential benefits for smoking cessation, uncertainties persist regarding their long-term safety and efficacy compared to licensed pharmaceutical interventions. Economic evaluations indicate the potential cost-effectiveness of e-cigs as a smoking cessation aid; however, regulatory frameworks and safety standards remain areas of concern. Further research is warranted to better understand the comparative effectiveness and safety of e-cigs, with an emphasis on long-term outcomes and the need for robust regulatory oversight to ensure their safe use as smoking cessation tools.