Smoking is implicated in various cancers, including lung cancer, but its effect on the cardiovascular system is somewhat less discussed. However, smoking profoundly affects our blood vessels and, ultimately, our long-term heart health. Smoking traditional cigarettes can worsen atherosclerosis (the narrowing of the arteries) both in the heart and peripheral extremities, causing problems with limb health and even dramatically increasing the risk of a heart attack. Traditional smoking also constricts blood vessels around the body, meaning that the heart must work harder to pump blood. For example, the body will have a more challenging time fighting off infection after an injury or surgery. Healing is often compromised too. With the advent of E-cigarettes and so-called vaping, many believe it is an appropriate and significantly lower-risk alternative to traditional tobacco products. But is this the case? Should vaping be considered a suitable option for those trying to quit smoking? There is a lot we know and even more that we don’t.