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In 2015, e-cigarettes worldwide was estimated to be 10 billion USD.[] Although there are fewer toxins than conventional tobacco smoke, toxins may vary widely depending on the brand.[] The selling of all e-cigarettes or vaping items has been officially prohibited in Saudi Arabia since September 2015.[] And for those over the age of 18 years, the personal use of e-cigarettes is reserved.[] In 2015, a meta-analysis found that relative to placebo, e-cigarettes helped tobacco cigarette smokers quit smoking.[] One the contrary, a study was conducted in 2020 found that frequent e-cigarette users on daily bases did not show a cessation advantage over comparable no-e-cigarette users, and use of e-cigarettes in that attempt compared to the FDA approved cessation aids or no products, showed similar abstinence rates in the next 2 years.[] However, its effectiveness in cessation aid is still being debated and unclear based on scientific evidence.[] By considering the harmful effects of e-cigarettes, there is evidence that suggests that e-cigarettes harm in mental health.[] In 2019, the study was conducted to assess the potential harmful effects of e-cigarettes on the developing brain end with the conclusion that both nicotine and non-nicotine components of e-cigarettes could potentially play a role in social maladjustments, including poor learning and academic performance, aggressiveness, poor sleep quality, attention deficits, depression, and suicidal ideation.[] In contrast, in March 2019, there has been an ongoing epidemic of acute lung injury secondary to the individual use of e-cigarettes, reported cases were more than 2600 and the term e-cigarette or vaping-product associated lung injury (EVALI) was established.[] However, the results of an article published by NEJM in April 2020 showed that among hospitalized patients with EVALI, chronic heart, and lung diseases are considered common.[] In a meta-analysis study of tobacco smoking prevalence among Saudi's college students that published in 2019 reported that the estimated pool of smoking prevalence was 17% and showed that males (prevalence rate of 26%) are more likely to smoke e-cigarettes compared to females (prevalence rate of 5%).[] In USA, a study conducted in Minnesota in 2018 showed that 14.7% of medical students had ever used e-cigarettes.[] After that, there were many studies conducted in Saudi Arabia

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