Electronic cigarettes, or electronic nicotine delivery systems (ENDS), include a variety of items, including vape pens, e-pipes, e-hookah, and e-cigars. They are battery-powered and can take a variety of shapes and sizes. ENDS contain an e-liquid that is heated to create a vapor that the user inhales. The liquid can include nicotine, along with other substances such as propylene glycol and vegetable glycerin. Many e-cigarettes also contain flavoring, which youths identified as a main factor in their use according to the 2018 report. “Some of the packaging, and the different flavors like candy or bubble gum – it just seems that they’re marketed to younger people,” Dr. Chiarchiaro says.