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Electronic nicotine dispensing systems (ENDS), commonly known as electronic cigarettes or e-cigarettes, have been popularly considered a less harmful alternative to conventional cigarette smoking since they first appeared on the market more than a decade ago. Both the electronic devices and the different e-liquids are easily available in shops or online stores. The long-term health effects of electronic cigarettes (e-cigarettes) are not fully understood, but the science indicates they are not a safe alternative to smoking. Most are noncombustible which includes a battery, a heating element, and a liquid compartment, usually containing addictive nicotine, that is added to the e-liquid or included in the device. The heating element aerosolizes the liquid for the inhalation of the liquid nicotine or other contents.

This guidance is intended to support healthcare providers in their understanding and tracking of -cigarette and vaping product use. 20% (5 million) of all youth use e-cigarettes, a 135% increase in just two years. Additional data, rates and trends can be found in the American Lung Association’s Tobacco Trends Brief.

Vaping works by heating liquid in a small device so you can breathe it into your lungs. The e-cigarette, vape pen or other vaping device heats the liquid in the device to create an aerosol. Mist from e-cigarettes contains particles of nicotine, flavoring and other substances suspended in air. You breathe these particles into your mouth from the mouthpiece, where they go down your throat and into your lungs. But, Blaha says, interpreting the data is tricky, since young people change their preferences often, and, when surveyed, may not consider using disposable products such as "puff bars" as vaping. The same CDC report says disposable e-cigarette use has increased 1,000% among high school students and 400% among middle school students since 2019.

Many e-cigarettes sold in the U.S. contain far more nicotine than e-cigarettes sold elsewhere, which increases the risk of addiction and harm to the developing brains of youth and young adults. Marketing tactics targeting young people have contributed to the rapid increase in use. The long-term risks of exclusive use of e-cigarettes are not fully known but evidence is accumulating that e-cigarette use has negative effects on the cardiovascular system and lungs.

However, a major concern about vaping is its attraction for young people. And, while it’s safe when taken orally as a supplement or used on the skin, it’s likely an irritant when inhaled. It’s been found in the lungs of people with severe, vaping-related damage. Some of these additives have health risks, such as diacetyl, which has a buttery taste. Diacetyl has been found to cause a severe lung disease similar to bronchiolitis. Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases FeNO levels of e-cigarette consumers.

Using e-cigarettes, or "vaping," are terms used synonymously to refer to the use of a wide variety of electronic, battery-operated devices that aerosolize, but do not burn, liquids to release nicotine and other substances. Nicotine-containing e-cigarettes are regulated as "tobacco products" by the FDA because the nicotine is derived from the tobacco plant. E-cigarettes pose a threat to the health of users and the harms are becoming increasingly apparent. In the past few years, the use of these products has increased at an alarming rate among young people in significant part because the newest, re-engineered generation of e-cigarettes more effectively delivers large amounts of nicotine to the brain.

If you think ENDS or other tobacco products are being sold to people who are underage, or you see another potential violation of the FD&amp