It is well known that smoking tobacco cigarettes is the leading preventable cause of mortality in the world. It is estimated that six million deaths occur annually worldwide due to tobacco smoking-related causes. In the USA alone, approximately 34.3 million Americans smoke with nearly 500,000 of them dying each year directly or indirectly due to tobacco smoking. The three major causes of smoking-related mortality are atherosclerotic cardiovascular disease (ASCVD), lung cancer, and chronic obstructive pulmonary disease (COPD). Tobacco smokers have decreased life expectancy and are more likely to develop tobacco-related diseases, including coronary heart disease (CHD), cancer, and pulmonary disease. As a result, consumers have turned to electronic cigarettes (e-cigarettes) to help stop smoking. The question remains whether e-cigarettes are safe and/or efficacious to aid in smoking cessation. E-cigarettes are battery operated devices that heat a liquid (e-liquid), which usually contains nicotine, and produces a vapor that the user inhales. In addition to nicotine, e-liquids have flavoring agents which contain diacetyl propionyl, propylene glycol, and aldehydes which are known carcinogens and teratogens. These agents also contribute to pulmonary and systemic inflammatory processes. There is uncertainty about the long-term health effects of vaping e-cigarettes in comparison to tobacco smoking.  There are also public health concerns about the effect of e-cigarettes on smoking prevalence, their potential use by children as a gateway drug, and the safety of the e-cigarette device. This presentation will evaluate primary literature to address the questions and concerns regarding e-cigarette safety, efficacy, and place in therapy for tobacco smoking cessation.