Cigarette smoking is the most common form of tobacco use worldwide, but other tobacco products, such as e-cigarettes, cigars, cigarillos, roll-your-own, pipes, and various smokeless tobacco products are also damaging. Most harmful chemicals in cigarette smoke target metals or carbonyls generated by the thermal decomposition of carrier liquids such as propylene glycol, which is one of the main ingredients in the liquid used in electronic cigarettes, where it serves as both the carrier for nicotine and cannabinoids and the means of producing vapor which resemble smoke. This new tobacco product was made of milder sorts of tobacco, the smoke could be inhaled, and it was more damaging.

Smoking primarily causes diseases of the respiratory system, cancer, and the cardiovascular system. E-cigarettes are battery-powered devices that heat a liquid, usually containing nicotine and flavorings, to generate an aerosol for inhalation. In 2014, there were already more than 450 different e-cigarettes with now different generations and more than 8000 different liquids.

The increasing prevalence of smoking among college students presents a significant public health and educational problem, particularly in developing countries where smoking prevention measures are not Strictly enforced .

A healthy lifestyle can reduce the risk of disease. One of the unhealthy lifestyle patterns is consuming cigarettes. Smoking can also reduce the affinity of oxygen for hemoglobin so that it can affect oxygen saturation levels in the blood. Cigarette smoke that enters the body through the lungs contains carbon monoxide and nicotine enters the blood, and then flows throughout the body, and this has an impact on the muscles becoming deprived of oxygen intake, which causes muscle work to be hampered so that the work of the heart will also be hindered because of blockage of blood vessels. It makes the heart pump harder, decreasing the heart's work power.

Wim Hof breathing exercise is part of a structured regimen, called the Wim Hof Method (WHM), which consists of three pillars (breathing, cold exposure, and mindset training). The WHM breathing exercise consists of three or more rounds, each comprising three phases; Hyperventilation, Breath retention, and Recovery breath. The use of Wim Hof breathing method is one of the effective breathing techniques, that increase the level of oxygenation and Quality of Life.

Inclusion Criteria:

• • The age of the subjects ranged from 18-29 years old.

  • The males are participated.
  • Any subjects smoking electronic cigarettes (vaping).
  • Subjects with body mass index between 18.5 - 29.9 Kg/m2.
  • Penn State Electronic Cigarette Dependence Index (moderate and high dependent) (Appendix 1) (Maraqa et al., 2024).

Exclusion Criteria:

• • History of syncope (fainting).

  • High blood pressure (>140/100 mm Hg) (Shandu et al., 2023a).
  • Any type of heart disease.
  • Seizures or Epilepsy.
  • Recent surgery.
  • Metabolic disorders.
  • Subjects with body mass index more than 35 Kg/m2.

A Randomized, Double-blind Controlled Clinical Trial (RCT) in which the selected subject will be divided randomly blinded into two groups (21 subjects for study group and 21 subjects for control group). In the study group, subjects in this group will receive Wim Hof Breathing Exercise every day in the morning or at least three hours postprandial and aerobic exercise (5 days/week) for four weeks. Subjects in the control group will receive only aerobic exercise (5 days/week) for four weeks.

Both groups will be evaluated at baseline and after the end of the treatment program.