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The rapid evolution in e-cigarettes complicates assessments of efficacy and safety.

First-generation vaporisers (also called 'cigalikes') resemble cigarettes and are most often used by new smokers. However Riccardo Polosa, director of the Institute of Internal Medicine and Clinical Immunology, University of Catania, Italy, pointed out that first generation e-cigarettes do not deliver as much nicotine into the blood as tobacco. In one study, peak serum nicotine concentrations were a tenth of that delivered by conventional cigarettes.

Second-generation devices do not resemble cigarettes and offer a greater choice of flavours and strengths, whereas thirdgeneration personalised ecigarettes and vaporisers (also called modified e-cigarettes or 'mods') allow users to exert even more control over taste and performance.

Second and third-generation devices typically deliver more nicotine into the blood than less sophisticated e-cigarettes, leading some studies to suggest that these devices improve the likelihood of cessation.

Have e-cigs reached a plateau?

Smoking Toolkit Study data show that e-cigarette use has begun to plateau. In the second quarter of 2011, 2.4 per cent of adults who smoked or who stopped in the past year had used e-cigarettes (2.0 per cent on a daily basis). By the third quarter of 2013, 21.5 per cent of current or recent smokers reported 'ever using' e-cigarettes, while 11.1 per cent used them daily.

But 12 months on, in the third quarter of 2014, only 21.8 per cent were reporting 'ever using' e-cigarettes, with 14.0 per cent using them daily. €The prevalence of e-cigarette use has not increased since... 2013,€ Professor West said. €We don't know the reason.€