The ENDS — electronic nicotine delivery systems — are not just near, but already here. As a family physician, I spend a significant portion of my day trying to get patients to quit smoking, or trying to get adolescents to not begin smoking. This has been a thorn in the physician’s side for years. 

While there is no doubt that there has been significant progress, 25% of adults still smoke cigarettes, down from approximately 50% of adults in the 1960s. 

This is rather ridiculous, since the first connection between cigarette smoke inhalation and lung cancer was initially suggested more than 90 years ago. So if we know the dangers of cigarettes are so great, why do people still begin smoking? While there are many contributing factors — including socioeconomic status, parental exposure, lack of education — I am convinced that in adolescents, the main reason they begin to smoke is to look older or cooler. 


Unfortunately, as we know, if one wishes to age more rapidly, physiologically speaking, smoking is a great way to speed up that process. 

When patients come in to work on smoking cessation, they frequently inquire about my thoughts on electronic cigarettes or vape pens and whether they are a viable aid for smoking cessation.  Many are already using vape pens or e-cigarettes by the time they get to me. Often they begin with dual usage in conjunction with combustible cigarettes.

While I am always happy when a patient expresses motivation to quit smoking, e-cigarettes (or ENDS) are not an FDA-approved method for smoking cessation.

“Vaping” is a new word in the dictionary — a verb meaning to inhale the vapor of an electronic cigarette or vapor pen. Who is using ENDS? A lot of people, including approximately 3 million high school- and middle school-age children. Most are under the impression that e-cigarettes and vape pens are not harmful.