E-cigarettes have many different forms, and the research thus far is inadequate to indicate using e-cigarettes helps to quit smoking tobacco. Furthermore, e-cigarettes still have harmful effects, particularly when coupled with existing COPD. Other statements indicate understanding of the harmful effects of smoking and understanding of the harmful effects that even second-hand smoke may have, particularly with the clinical picture of COPD. While chewing tobacco’s negative effects may not be as directly related to COPD exacerbation as smoking tobacco, it is nevertheless a harmful habit that can lead to gingival, mouth, and throat cancer.