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In a recent, comprehensive report issued by the United Kingdom, the governments chief medical officer expressed caution regarding the lack of evidence on the long-term use of e-cigarettes but noted that the available evidence shows that e-cigarettes carry just a fraction of the harm. However, with the large number of flavor-generating additives in e-cigarettes, wide variation in e-liquid composition, and, in particular, lack of long-term research, questions remain as to whether e-cigarettes are truly a less harmful method of nicotine delivery

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However, as in any cross-sectional study, we could not establish causal association between tobacco consumptions and its determinants