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A 2016 study found that people who use or have used e-cigarettes are less likely to stop smoking altogether. Flavors vary widely, from "traditional" and menthol to watermelon and "lava flow." Some e-cigarettes taste like traditional cigarettes and even mimic the tastes of specific brands. When the user sucks on the mouthpiece, the heating element vaporizes the solution, which the person then "vapes," or inhales. The nicotine content of the liquid can range from "very high" to zero. Refills come in flavors such as cool cucumber, mango, and mint, which may seem natural and harmless, but a single JUUL refill contains as much nicotine as a pack of 20 cigarettes. To inform this work and evaluate the effectiveness of policy, the CDC Foundation is collecting and analyzing information about e-cigarette sales, teen e-cigarette use, and teens’ attitudes about the epidemic.

The Centers for Disease Control and Prevention (CDC) report that vaping nicotine can permanently affect brain development in people under the age of 25. The researchers concluded that vaping with and without nicotine disrupts typical lung function in otherwise healthy people. The researchers reported a number of adverse effects on both types of cells, including toxicity, oxidation, and inflammation. However, these results aren’t necessarily generalizable to vaping in real life. A 2019 study assessed data from a nationwide survey of nearly 450,000 participants and found no significant association between e-cigarette use and heart disease. The authors also described moderate evidence suggesting that taking a puff from an e-cigarette increases blood pressure.

Although e-cigarettes do not give off smoke like tobacco cigarettes, they do expose people to secondhand aerosol or "vapor" that may contain harmful substances. Scientists are still learning about the health effects of being exposed to secondhand e-cigarette aerosol. The FDA monitors the national usage rates for all tobacco products, including an annual youth survey, and has seen a drastic increase in youth use of e-cigarette products in recent years.

Current evidence indicates that using e-cigarettes is dangerous, especially for young people and people who have never smoked. In young people, the use of nicotine can impact the reward system in the brain. In time, this can make the use of other drugs, such as cocaine, more pleasurable, according to the National Institute on Drug Abuse (NIDA).

When I exhale, the vapor is gone within 10 seconds, along with the smell. Funny how just about 10 years ago people were still allowed to smoke actual cigarettes in some restaurants and I didn’t see anyone walking out on their meal due to the smell coming from the smoking section. I’m not saying it was a wonderful arrangement, but people dealt with it.

Youth ENDS use raises concerns about nicotine addiction, negative effects of nicotine on adolescent brain development, and other potential health harms, including increased risk of initiating cigarette smoking. Electronic nicotine delivery systems (ENDS), also called electronic cigarettes, e-cigarettes, vaping devices, or vape pens, are battery-powered devices used to smoke or "vape" a flavored or unflavored solution which usually contains nicotine. The American Academy of Family Physicians (AAFP) recognizes the increased use of ENDS, especially among youth and young adults, as well as its use by those attempting to quit smoking tobacco. Although e-cigarettes do not contain tobacco, for regulatory purposes, they are considered "tobacco products" by the US Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC). E-cigarettes can go by different names, including vapes, vape pens or sticks, e-hookahs, hookah sticks, mods, and personal vaporizers.

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