For years, health authorities have encouraged people to stop smoking and not start young people. Electronic cigarettes complicate their message.
For more than 40 years, the American Cancer Society's Great American Smokeout has encouraged people to stop smoking and reduce the risk of lung and other cancers, heart attacks, strokes and other diseases.
This has had a major impact on the smoking rate, along with a message that prevents young people from smoking in the first place.
From 1978 to 2014, smoking rates among American adults fell from 34.1% to 16.8%. The proportion of teens also dropped sharply since the late 1990s.
However, the growing popularity of electronic cigarettes complicates the attitude of cigarette public health professionals.
An oncologist even claimed to include an electronic cigarette at the Great American Smokeout on November 15 to prevent current users of nicotine-filled vapes from becoming "tomorrow's tobacco patients".
Hill says Dr. Peter Shields, deputy director of the Ohio State Comprehensive Cancer Center, is "little known" about the safety of vaping.
He also points out that millions of teenagers are trying to binge on the risk of nicotine addiction and tobacco use.
Not everyone agrees. Dr. Daniel Giovenco, an assistant professor at Columbia University's Mailman School of Public Health, warns against smearing blood and cigarette smoke together.
"Including vaping in the great American Smokeout can endure a common misconception that electronic cigarettes are as harmful as cigarettes," he said.
E-cigarette vapors contain far fewer chemicals than cigarette chemicals, and there are thousands of chemicals.
Electronic cigarettes can be less harmful than traditional cigarettes, but they are not at risk.
Aerosols of electronic cigarettes can contain nicotine, lead, and cancer-causing chemicals as well as fine particles that can affect lung or heart function during inhalation.
Some studies have found an association between vasodilation and increased risk of heart attack and lung disease.
More research is needed and is in progress.
This includes research at the Ohio State University Comprehensive Cancer Center that uses bronchoscopy to investigate the effects of e-cigarette users, smokeless tobacco users, and non-smokers on the lungs.
Whether the electronic cigarette is "good" or "bad" depends on the situation.
Giovenco said adult cigarette smokers could "reduce their exposure to the many deadly toxic substances contained in burnt cigarettes by switching completely to cigarette smoking products."
This kind of harm reduction approach helps people switch from harmful activities to less harmful activities.
However, if people continue to smoke traditional cigarettes – even with vaping – there is a health risk.
"For adult smokers, it's a win if e-cigarettes help stop smoking," Shields said. "But if electronic cigarettes smother smokers and smoke, it is not a victory."
Some research also suggests that electronic cigarettes can be a gateway to smoking to young people. So there is a concern that vape young people will become addicted to nicotine.
"Young people should not use nicotine," Giovenco said. "So the message of abstinence may be appropriate for that population."
Giovenco said that after the electronic cigarette was put on the market, the cigarette smoking rate continued to decline and this did not affect the fight against existing cigarette smoking.
But the use of electronic cigarettes is still important among young people, he added.
"It is currently a challenge to find a balance between encouraging adoption among smokers who can not quit using other methods, and reducing teens' attraction to electronic cigarettes," Giovenco said.
This means that public health messages for adult smokers and teen nonsmokers are separate.
Your doctor should open up the use of electronic cigarettes so that the patient can give up smoking.
"If the patient says that electronic cigarettes are the only way to stop smoking, do not tell them to stop using them," Shields said. "But if e-cigs is not working, we ask the patient to call me so we know we're working."
Proven smoking cessation tools include nicotine replacement therapies and prescription drugs.
According to the Centers for Disease Control and Prevention (CDC), smoking is still the leading cause of smoking, with annual smoking rates exceeding 480,000, despite a sharp decline in smoking rates.
The continued passage of tobacco to the health of the nation may mean that healthcare professionals must go beyond the "good" or "bad" of electronic cigarettes.
Giovenco said, "When smoking should be abolished, it may be preferable to smoke."