The development of e-cigarettes has renewed interest in products that reduce the harm from tobacco use. This column argues that recent research appearing to demonstrate a link between e-cigarettes and respiratory disease does not tell the whole story. Adopting a more flexible empirical specification that takes into account whether people are never smokers, former smokers or current smokers, the authors find no evidence that current or former e-cigarette use is associated with respiratory disease among respondents who had never smoked combustible tobacco. Moreover, while dual users are more likely to develop respiratory disease than non-smokers, there do not appear to be significant differences between dual users and smokers.