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Large public health entities have reviewed the evidence on e-cigarettes and concluded that e-cigarettes are less harmful than combustible cigarettes, with the short-term health risks of e-cigarettes being substantially less than the risks of combustible cigarettes. The long-term health effects are still largely unknown because of the relatively short time e-cigarettes have been on the market; but recent studies suggest that long-term e-cigarette use may alleviate some of the health burdens of tobacco smoking, such as associated conditions like COPD. If we move smokers down the continuum of risk, away from harmful tobacco products like combustible cigarettes and towards safer nicotine alternatives, millions of lives will be saved.