AbstractSmoking is the most important risk factor for peripheral arterial occlusive disease (paod). Smoking cessation is and remains the gold standard in the secondary prevention recommendation. E-cigarettes/tobacco heaters are recommended for smokers who are unable to stop smoking or who do not want it. According to the recommendation of the German Society of Addiction, switching to e-cigarettes/tobacco heaters in this group of smokers, who are not accessible for smoking cessation strategies, can achieve a more than 90 % reduction of pollutant exposure. However, physicians who treat vascular patients in Germany lack fundamental knowledge about the variety of e-cigarettes/tobacco heaters, their handling and their emissions. Therefore, an open and professional discussion among cardiologists, angiologists and vascular surgeons on smoking cessation and harm reduction is necessary.