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Considered that only limited information is available about the health impact of combustion-free nicotine delivery alternatives in COPD, a research team of CoEHAR (Center of Excellence for the Acceleration of HArm Reduction) led by its founder professor Riccardo Polosa, authored this state-of-the-art review article to carefully identify and critically appraise the existing evidence from human studies on the respiratory health effects of ECs/HTPs substitution for COPD patients who smoke