Abstract

Electronic cigarettes, also known as electronic nicotine delivery systems (ENDS), have emerged over the past decade as alternatives to conventional tobacco products. Initially promoted as harm-reduction tools for adult smokers, they have rapidly gained popularity among adolescents, creating new challenges for healthcare professionals and families. ENDS are battery-powered devices that heat a liquid generally composed of nicotine, propylene glycol, vegetable glycerin, and various flavorings, producing an inhaled aerosol. The aerosol contains nicotine and other potentially toxic substances, contributing to dependence and exposing users to respiratory, cardiovascular, and systemic risks. From a public health prevention perspective, it is essential that physicians, parents, and educators understand the appeal of these devices, which is often associated with social trends and digital influences. Providing clear information, fostering open dialogue, and promoting critical thinking regarding advertising messages are key strategies to support adolescents and prevent early initiation of nicotine use. This narrative review synthesizes current evidence on the toxicological profile, usage patterns, and health risks associated with ENDS.