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Vape And Ends: The New Cool Thing To Do

My patients don’t smoke cigarettes. They have heard the message that cigarettes are bad for you and contribute to lung cancer. Instead they are turning to Electronic Nicotine Delivery Systems (ENDS), such as e-cigarettes, vape pens, personal vaporizers, and e-hookah. Unfortunately, kids/teens haven’t been given the correct message that ENDS are also dangerous. They somehow mistakenly believe that they are a safe alternative. The use of ENDS (specifically “vaping” in our community) is so widespread that I no longer ask teens, “if” they vape, but “when” they last vaped.

If you haven’t heard, ENDS are all different ways of aerosolizing a liquid by different forms of smoking or inhaling it. The liquid solution is a mixture of nicotine, flavors, and other chemicals. The baffling disconnect here is that kids know that nicotine is addictive and harmful, yet somehow they don’t recognize the dangers of using ENDS. The folks working for these industries are brilliant. They have effectively managed to reinvent a harmful product and market it to a new generation as harmless and cool.

How do I recognize ENDS?

An ENDS device has to be powered in some fashion (either by battery or a USB port). The components are an indicator light, battery/power source, vaporizer, cartridge, and mouthpiece. There is always somewhere that the liquid solution goes in. ENDS typically look like pens, flash drives, pipes, flashlights, pipes, cigars, or cigarettes.

ENDS Facts:

  1. ENDS are the most commonly used tobacco products among youth. According to the Centers for Disease Control and Prevention (CDC) 2015 Youth Risk Behavior Survey, 24% of high school students report currently using e-cigarettes (not just tried it). This number is on par with the numbers of teens in my practice who admit to using, and consider that’s in conservative Utah.
  2. The liquid mixture can have many harmful chemicals (e.g., nicotine, anti-freeze, diethylene glycol, and carcinogens like nitrosamines).
  3. The liquid has nicotine, which is a highly addictive, harmful drug.
  4. The liquids come in all every imaginable tempting flavor (bubble gum, fruits, chocolate, coffee, etc.).
  5. ENDS are not FDA approved for smoking cessation.
  6. The liquid that contains nicotine, even amounts as small as little ½ teaspoon, can be fatal for a child (according to the American Academy of Pediatrics. See
  7. ENDS are easily accessible to youth. While it’s illegal to sell to youth under 18, it can be easily ordered online.
  8. ENDS are unsafe, secondhand exposure is harmful, and kids who use e-cigarettes are more likely to use other tobacco products (all according to the 2016 Report from the U.S. Surgeon General)

Know about ENDS. Most parents have at least heard of e-cigarettes, but assume their teen isn’t using them. Don’t assume your kid isn’t involved. Unfortunately, it’s one more thing I need to add to my list of things to warn my own children about.