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A 2019 randomized control study also found that daily e-cigarette use leads to an almost doubled rate of smoking abstinence than other nicotine-replacement products after one year. Vaping involves breathing in an aerosol that contains several chemicals, including nicotine and flavoring, through an e-cigarette or vape. SAMHSA's mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes.

E-cigarettes first entered the market in 2007 and have evolved many times since then, with older versions designed to resemble regular cigarettes, cigars, pipes, and pens. E-cigarettes next evolved into "pod mods" with e-liquid sold in disposable pods. In 2015, the emergence of the brand JUUL took pod mods to the next level with high tech design, high-nicotine delivery, and youth- appealing marketing that hooked a new generation to nicotine. Without regulations, it is the "Wild West" for e-cigarette companies, says Stanton Glantz, director of the Center for Tobacco Control Research and Education at the University of California, San Francisco, and a self-described e-cigarette pessimist. He argues that given the paucity of health data, current indoor smoking bans should apply to e-cigs as well.

Despite the general decline in smoking, it remains more prevalent among youth with lower socio-economic position (SEP). This has been observed with family-level SEP indicators, including parental education [3, 4] and family affluence [5]as well as individual-level indicators of adulthood SEP such as academic performance [4, 5] and vocational education [6–8]. For smokeless tobacco (snus) use and electronic cigarette (e-cigarette) use, the associations with SEP have been mixed [7, 9, 10]. The scientists investigated the effect of the e-liquids on cells called endothelial cells that line the interior of blood vessels.

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