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Image from Trudy Watson 1991 Asthma Guidelines The first Expert Panel Report "Guidelines for the Diagnosis and Management of Asthma" was published in 1991

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[26] [27] [28] Peer-reviewed studies have quantified microfiber shedding from cigarette filters in water over time, reporting average releases of ~5.7892.43 microfiber items per gram of filter after 160 days, and estimating that cigarette filters may release tens of trillions of microfibers annually into aquatic environments

It explains that no tobacco product is safe, and that e cigarettes are not risk free even when they may be lower risk than cigarettes for adults who smoke and switch completely