For nearly thirty years, Sarah had not yet joined the caravan of smokers, until she tried flavored electronic cigarettes, and at that time she specifically preferred the raspberry flavour.
After that, the e-cigarette led her to smoke traditional cigarettes.
Sarah, who works in the design field in Jordan and is the mother of a five-year-old child, told the BBC that three years ago, the electronic cigarette, or what is known as vape, entered my life. It was not important to me at first, but its pleasant taste and the atmosphere of smokers around me pushed me to get used to it.
Later, the “sweetness” of e-cigarette flavors prompted Sarah to take a traditional cigarette in order to get a bitter taste. “Over and over again, I preferred the traditional cigarette,” she says.
She adds that the electronic cigarette was an outlet for her from the pressures of work and life, and “something to entertain her from eating,” but she replaced it with traditional smoke, after she felt that the electronic cigarette caused her a strong cough, a pain in the throat, and a feeling of suffocation at times.
In a report published by the World Health Organization in 2025, it pointed out that tobacco and nicotine companies often promote “e-cigarettes as a safer alternative to smoking, but in reality they attract a new generation of users, especially young people, through products with various flavors, attractive packaging, and misleading health claims.”
According to a report by the organization also published in 2025, more than 100 million people in the world use e-cigarettes.
Attractive flavor and desire to keep up
Salim (a pseudonym) is 18 years old and in high school in Jordan. He started smoking electronic cigarettes about a year ago, and before that he had never tried any type of smoke, as he says.
His curiosity and desire to keep up with the smokers around him led him to try smoking an e-cigarette, “especially since it has a nice flavour,” and also for fun. Now, he smokes traditional cigarettes as well as electronic cigarettes.
As for Rawan (a pseudonym), who is 24 years old and works in the culinary field in Jordan (chef), she started smoking when she was a university student at the age of 22. She says that she smoked the electronic cigarette because at that time “it was a trend, and everyone around me was smoking,” and she chose “vaping” because “it smells nice and not like the annoying smell of smoke.”
After a year, Rawan began to feel chest pains, which prompted her to quit smoking.
The World Health Organization says in another report published in 2026 that levels of tobacco use among young people in the Eastern Mediterranean region are one of the highest in the world, as estimates indicate that 5.5 million children between the ages of 13 and 15 years in the countries of this region are smokers.
Globally, the organization says that “teenagers are nine times more likely to use e-cigarettes than adults. In the Eastern Mediterranean region, “the levels of use of e-cigarettes among adolescents, specifically among young boys, are alarming, as the percentage in some regions reaches 30 percent.”
It also stated in its report for the year 2025 that estimates indicate that at least 15 million children in the age group (13-15) years in the world smoke electronic cigarettes, and at least 86 million adults use electronic cigarettes.
Dr. Larissa Al-War, the founding member of the No Smoking Association in Jordan, believes that the electronic cigarette “is used as an attractive factor due to the presence of different flavors and colors,” and explains that it is a way to “promote a modern product in an attempt to remove the risk factor through multiple shapes and flavors and market it as less harmful.”
Al-War adds that the electronic cigarette “does not have the smell of smoke or an unpleasant smell, which makes it easy for teenagers, for example, to use it without their parents’ knowledge due to the ease of using it without the need to light a (traditional) cigarette in classrooms and universities.”
Is electronic cigarette safe?
Moamen (31 years old), who works as a customer service officer in a bank in Egypt, started smoking when he was fourteen years old, by smoking “shisha/hookah”, and then moved on shortly thereafter to smoking traditional cigarettes.
But 3 years ago, after reading a British scientific article that said the harms of electronic cigarettes were less than those of traditional cigarettes, he started smoking them as an alternative that might push him to give up smoking, but he now smokes both types, he says.
To clarify, the British Health Organization (NHS) said in a report published in 2022 and updated in 2026 that smokers can use electronic cigarettes that contain nicotine as less harmful than traditional smoking, to help them quit smoking.
But the organization also urged that e-cigarettes should not be used among non-smokers or children, as the use of e-cigarettes is not completely risk-free, and "the long-term effects of this use are not yet known."
It is noteworthy that the British government has banned single-use e-cigarettes “that are not rechargeable or refillable - disposable,” as of June 1, 2025, to limit their “worrying” spread in school playgrounds, and to limit their use among children, and for environmental reasons.
Chest and respiratory care consultant Dr. Mai Allam, who works in Egypt, says that the belief that there is no harm from electronic cigarettes is due to the idea that “there is no combustion process.” But she explains that medical research has confirmed that electronic cigarettes are not safe, even if their harm is “relatively less,” compared to electronic cigarettes.
Allam explains, “Vaping relies on vaporization (heating the liquid so that it volatilizes in the form of a mist), and thus the user avoids inhaling tar and direct solid products of combustion. But vaping replaces the risks of combustion with other risks related to inhaling chemical solvents and artificial flavors that settle inside the alveoli of the lungs.”
For her part, Al-War says, “I want to stress that there is no such thing as less harmful, but rather different harmful, especially since it contains high levels of nicotine, which causes addiction.”
She adds that some parents have begun to “buy electronic cigarettes for their children,” noting that “in addition to the danger of nicotine, there is a danger resulting from the chemicals found in this type of cigarette.”
The World Health Organization explains that e-cigarettes, whether electronic nicotine delivery systems (ENDS) or electronic non-nicotine delivery systems (ENNDS), heat a liquid to generate an aerosol that the user inhales.
She says that these liquids, known as “e-liquids,” do not contain tobacco, but they may contain nicotine. They also usually include additives, flavors, and chemicals that may be harmful to human health.
The organization also explains that “e-cigarette emissions usually contain nicotine and other toxic substances that are harmful,” whether to smokers or those who are exposed to them indirectly. It was also found that "some products that claim to be nicotine-free actually contain nicotine."
Lung for "clean breathing"
High-quality epidemiological studies have consistently demonstrated that e-cigarette use increases rates of traditional cigarette smoking by approximately 3 times, especially among young non-smokers, according to the World Health Organization.
“Research has also recorded an increase in cases of premature hardening of the arteries and poor endothelial efficiency in young people addicted to e-cigarettes compared to non-smokers,” says Dr. Mai Allam.
She also adds that smoking e-cigarettes may expose the smoker to bronchiolitis obliterans, known as “popcorn lung.”
Dr. Larissa Alor explains that in addition to the diseases known so far as a result of smoking electronic cigarettes, such as “popcorn lung,” the dangers of smoking this type “may appear after many years of 10-15 years, and we do not want our children to be guinea pigs for tobacco companies.”
She adds, "God created the lungs for clean breathing."
She also says: “Exposure of pregnant women to nicotine negatively affects the development of the fetus, and the consumption of nicotine by children and adolescents has negative effects on brain development, which has long-term consequences on its development and potentially causes them to develop learning and anxiety disorders.”
Although “the long-term health effects of these products are not fully known, we know very well that they generate toxic substances, some of which are known to cause cancer and others to increase the risk of heart and lung disorders,” emphasizes the World Health Organization.
