Document is current

Article History

Received: 16 March 2026

Revised: 22 May 2026

Accepted: 29 May 2026

First Online: 4 June 2026

Competing interests

: Yusuff Adebayo Adebisi received funding in the past through the Tobacco Harm Reduction Scholarship and the Kevin Molloy Fellowship, both awarded by Knowledge-Action-Change (KAC) UK, an independent public health organisation. KAC receives funding from Global Action to End Smoking (GA), an independent U.S. nonprofit 501(c)(3) grantmaking organisation that supports health and science research, cessation education, and agricultural transformation initiatives. Massimo Volpe has received honoraria for speakers’ bureau or advisory board from; Astra Zeneca, Menarini, GSK, Pfizer, Sanofi, Servier, and is supported by a Grant from the Italian Ministry of Health (“Ricerca Corrente”). Riccardo Polosa is a full tenured Professor of Internal Medicine at the University of Catania, Italy, and Medical Director of the Institute for Internal Medicine at the same university. He has received EU and governmental competitive grants, including U-BIOPRED, AIR-PROM, Integral Rheumatology & Immunology Specialists Network (IRIS), and several PNRR grants funded by NextGenerationEU of the European Commission. He has also received investigator-initiated grants from GA, Pfizer, GlaxoSmithKline, CV Therapeutics, NeuroSearch A/S, Sandoz, Merck Sharp & Dohme, Boehringer Ingelheim, Novartis, Arbi Group Srl., Duska Therapeutics, and Forest Laboratories. He is the founder of the Center for Tobacco Prevention and Treatment (CPCT) and the Center of Excellence for the Acceleration of Harm Reduction at the University of Catania. He has received consultancy fees from Pfizer, Boehringer Ingelheim, Duska Therapeutics, Forest Laboratories, CV Therapeutics, Sermo Inc., GRG Health, Clarivate Analytics, Guidepoint Expert Network, and GLG Group. He receives textbook royalties from Elsevier and EDRA. He is also Chair of the European Technical Committee for Standardisation on “Requirements and test methods for emissions of electronic cigarettes” (CEN/TC 437; WG4) and scientific advisor to the non-profit Foundation RIDE2Med. All other authors declare no competing interests. This research was conducted independently and is not linked to any prior funding sources.

: This study is a secondary analysis of anonymised data from the Scottish Health Survey. Ethical approval for the Scottish Health Survey was obtained by the survey organisers, and all participants provided informed consent. No additional ethical approval was required for this secondary analysis. All methods were performed in accordance with relevant ethical guidelines and regulations.