There is no clear regulation on electronic cigarettes (e-cig); their health effects are not yet fully investigated and there is insufficient standardisation and quality control of the product. Moreover, the e-cig could be a gateway for young people to nicotine addiction and traditional cigarette smoking. In Italy, the Ministry of Health banned the sale of e-cig with nicotine firstly to adolescents aged <16 years, then to people <18 years. Until further scientific evidence is available, it is mandatory to regulate the production and marketing of e-cigs, to make them less attractive, to forbid their use in enclosed areas, and prevent them from being promoted. E-cigs, however, seem to be much less dangerous than traditional cigarettes, although the few studies conducted are not sufficient to demonstrate either a clear therapeutic efficacy of e-cig or their total harmlessness. If e-cig had a known content, were made according to clear rules and in certified laboratories, without toxic substances, it could be used to help heavy smokers to quit, or at least to reduce smoking habits. There is a large proportion of smokers who are unable to quit. The revision of the European Directive (the proposal is being evaluated and we are waiting for its final approval) on tobacco recommends free sale for a minority of e-cigs only, those with a nicotine content <4 mg/ml. This will be difficult, considering that the business is just the free sale of e-cig and the much more dangerous tobacco cigarettes are still sold without any restriction.