Introduction:
Electronic cigarettes (ECs) deliver nicotine without tobacco combustion by vaporizing liquids or heating specific sticks (Heat-not-burn Tobacco Products, HTP). The use of ECs is rising, particularly among young people, raising concerns about their potentially harmful health effects.

Material and Methods:
We administered an anonymous online questionnaire to patients aged 12 to 18 years followed at our clinics due to respiratory and allergic morbidities. The questionnaire was divided into three sections: 1) knowledge about the risks of electronic smoking; 2) the AECQ questionnaire on expectations regarding ECs’ use; and 3) the ECAS questionnaire on the attitudes towards ECs.

Results:
Fifty-seven adolescents were recruited between October 2023 and June 2024 (mean age 14.1 years, 68% males). 80% acknowledged that ECs do not help with smoking cessation and that they can be as harmful as traditional cigarettes, whereas less than 25% were aware of the health risks of second-hand vaping. Additionally, 78% did not know third-hand smoke. Furthermore, 31% were unsure if vaping during pregnancy is risky for the fetus, and 52% were unaware that nicotine contained in ECs can cross the placenta. Regarding HTP, 40% were uncertain about the ability to induce addiction, and 60% were more generally unaware of their detrimental effects. At the same time, 80% recognized the importance of educating the youth population about the health risks of electronic smoking.

Conclusions:
Our study highlights the alarming lack of awareness among adolescents about vaping-related health risks. Given the ever-growing relevance of electronic cigarettes as a worldwide health concern, urgent educational and preventive measures are of main interest, especially in the pediatric population.