E-cigarette use is associated with an increased risk of respiratory symptoms. Young people are at risk of experiencing significant respiratory symptoms, including bronchitis and shortness of breath, after just 30 days of electronic cigarette use. Current e-cigarette use was associated with an increased risk of emergency room visits and death.

The World Health Organization (WHO) has warned that all forms of tobacco, including heated tobacco products (HTPs), are harmful. E-cigarettes as consumer products are not shown to be effective for quitting tobacco use at the population level, and alarming evidence has emerged on adverse population health effects. Urgent action is needed to control e-cigarettes to protect children, and non-smokers and to minimize health harms to the population.

By contrast, in high-income and European countries annual consumption declined by over 1,000 cigarettes per adult after 2003, whereas in low- and middle-income and Asian countries annual consumption increased by over 500 cigarettes per adult.

Smoking is associated with an increased risk of suffering from a wider range of COVID-19 symptoms and smokers are more likely to visit hospital than non-smokers.

Dual use of both e-cigarettes and cigarettes has higher risk of having a heart attack than cigarette use only. Similarly, dual and solely e-cigarette users are at a higher risk of heart attack than non-smokers.

About 362 million adults from 165 countries currently use smokeless tobacco – 259 million men and 103 million women. Most (280 million or 77%) smokeless tobacco users live in the South-East Asia Region (24.9% of males and 11.8% of females), while the Western Pacific Region has at least 21 million smokeless tobacco users. Each WHO region is estimated to have at least 10 million adult smokeless tobacco users.

More than 85% of the smokeless tobacco-related burden is in South and Southeast Asia and the risk estimates for cancers are highest in this region. In 2017, at least 2.5 million DALYs and 90,791 lives were lost across the globe due to oral, pharyngeal and oesophageal cancers that can be attributed to smokeless tobacco.

Smokers who quit before the age of 50 had their risk of lung cancer fall 57% over the follow-up period compared with those who continued to puff. Those who quit at 50 or older experienced a 40% reduction in lung cancer risk over that time.

Globally, an estimated 9.7% of 13-15 year olds use tobacco products, 25 million boys and 12 million girls. Around 5 million adolescent cigarette smokers – or 26% of the global number – live in the South-East Asia Region. Around 9 million adolescent cigarette smokers – or 47% of the global total – live in lower-middle-income countries and another 2 million live in low-income countries.

Children 13-15 years old are using e-cigarettes at rates higher than adults in all WHO regions. E-cigarettes as consumer products are not shown to be effective for quitting tobacco use at the population level. Instead, alarming evidence has emerged on adverse population health effects.

Adolescents who use electronic nicotine delivery systems (ENDS) are three to five times more likely to start smoking tobacco cigarettes compared to those who never used ENDS.

Multinational tobacco companies target minors worldwide using strategies to advertise and promote cigarettes at points-of-sale near schools and playgrounds. Four common strategies include (1) display of cigarettes near snacks, sweets and sugary drinks, (2) placement of cigarette advertisements near the eye-level of children, (3) advertisements and display of flavoured cigarettes and (4) sale of single sticks of cigarettes.