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Ultra-structural abnormalities, mostly affecting axonemal microtubules and tail alterations, have been reported in heavy smokers [28, 29]

Specifically, the NHS recommend e-cigarettes as a less harmful alternative to smoking [4] In Australia vapes are legal but is publicly recommended not to use electronic cigarettes

Indigenous peoples across the Americas, Asia, and the Middle East used mullein, uva ursi, red willow bark, and aromatic herbs in ritual contexts, often precisely because the act of smoking was considered a form of prayer: breath made visible, intention carried on smoke toward the sky

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It is reasonable to conclude that SHS significantly increases the risk of developing bladder cancer, although there is uncertainty over the precise level of risk

Conclusion: Smokers or former smokers who switch to e-cigarettes may reduce their exposure to carcinogens and lower their risk of developing severe health issues associated with conventional smoking