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The Centers for Disease Control and Prevention reports that nicotine can also harm parts of the brain that control attention, mood and impulse control. Electronic Nicotine Delivery Systems (ENDS) represent a rapidly changing class of tobacco products known by many different names, including e-cigarettes, e-cigs, vapes, mods, and tank systems. ENDS deliver an aerosol to the user that typically contains nicotine, propylene glycol, vegetable glycerin and flavoring chemicals. In 2018, 3.2% of U.S. adults (age 18 and older) reported current ("every day" or "someday") use of ENDS. Since 2014, ENDS have been the most used tobacco product among U.S. youth. In 2020, about 3.6 million U.S. youth, including about 1 in 5 high school students and 1 in 20 middle school students, reported current (past 30 day) use of ENDS.

So, if you are vaping to quit smoking, you should aim to eventually stop vaping too. In 2022, UK experts reviewed the international evidence and found that "in the short and medium term, vaping poses a small fraction of the risks of smoking". Vapes are electronic devices that let you inhale nicotine in an aerosol, or vapour, instead of smoke. This is done by heating a solution (e-liquid) that typically contains propylene glycol, vegetable glycerine, flavourings and nicotine. Vapes come in many shapes and sizes but they have the same basic components, including a battery, sensor, and atomizer/ flavor cartridge.

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.

Of note, the abstinence rate found in the nicotine-replacement group was lower than what is usually expected with this therapy. Nevertheless, the incidence of throat and mouth irritation was higher in the e-cigarette group than in the nicotine-replacement group (65.3% vs. 51.2%, respectively). Also, the participant adherence to the treatment after 1-year abstinence was significantly higher in the e-cigarette group (80%) than in nicotine-replacement products group (9%) [100]. These data overall indicate that the harmful effects of nicotine should not be underestimated. Despite the established regulations, some inaccuracies in nicotine content labelling remain in different brands of e-liquids.

U.S. Surgeon General Vivek Murthy, MD, MBA, also highlighted that vaping "could be a major form of harm reduction for adults," although "not zero risk," but expressed strong concern over youth vaping. With the increasing use of e‑cigarettes, there has been greater support for policies aimed at controlling the prevalence of e‑cigarettes. You may also want to make an appointment with a doctor if you think vaping is behind any new symptoms, such as coughing, difficulty breathing, or increased heart rate.

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