Electronic nicotine delivery systems (ENDS) heat a liquid, which typically contains nicotine, to an aerosol that is inhaled.16 ENDS include vaporizers, vape pens, hookah pens, e-pipes and e-cigarettes. The increase in use of ENDS by youth is more rapid than in adults. National surveys indicate that 5% of adults use ENDS compared to 16% of high school students. Of further concern are reports that the use of ENDS among high school students in 2011 was 1.5% but increased to 16% by 2015.16 These data demonstrating an increase in ENDS use is partially the result of the user’s belief that these products are less harmful than other tobacco products. The CDC has issued statements that these products are not less harmful. Evidence to support ENDS as a tobacco cessation aid is limited and of low quality. As a result, ENDS are not an FDA-approved cessation aid.