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[I]t is appropriate to consider potential hazards of e-cigarettes, the authors wrote, but they emphasized that this analysis should be carried out relative to the impacts of smoking: [A]s smoking cessation is associated with a reduction in respiratory symptoms in people with respiratory disease, many smokers who switch to an e-cigarette are likely to experience improvements in respiratory symptoms

doi: 10.1016/j.jgo.2019.02.011 16 OReillyEMLeeJWZalupskiMCapanuMParkJGolanTet al

If symptoms persist despite lifestyle changes and medication, or if difficulty swallowing, unintended weight loss, or chronic chest pain occurs, medical evaluation is necessary

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With adequate data (both safety, effectiveness and consumer label comprehension), some drugs, including several NRTs, have been able to make the Rx-to-OTC switch