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Electronic Nicotine Delivery Systems ( Ends )

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In 2003, Electronic Nicotine Delivery Systems (ENDS) were first manufactured in China. These products were later debuted in the U.S. market in 2006 as novel tobacco products and have been gaining popularity since (1,2,3). ENDS, such as e-cigarettes, are battery powered devices that heat a solution typically containing nicotine in order to create a vapor without the combustion of tobacco. This liquid is inhaled into the lungs and then exhaled similar to traditional cigarettes. The solution, also known as e-liquid, can contain various levels of nicotine (including no nicotine) and is available in various flavors (2,3,4).
ENDS are widely available at retail outlets such as mall kiosks in shopping malls, online stores, gas stations, and several other locations (5). Marketed as an alternative to nicotine delivery and advertised as a smoking cessation tool, products such as e-cigarettes, e-hookahs, e-cigars, various flavored e-liquids, and other ENDS components are readily sold. While the average concentration of nicotine resulting from smoking traditional cigarettes was found to be 10 times greater than that of ENDS, the perceived risks and health benefits of these products as being safe alternatives or cessation devices have caused controversy (6).
1.2 Purpose of Study
Studies have found that since 2006, the awareness and prevalence of use of ENDs has increased significantly among both youth and adults. The large increase in use, especially among youth, has brought a large

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