Vaping—Reply

In Reply We thank Dr Marynak and colleagues for their Letter in response to our Insights article “Vaping in Youth” and agree that illegal vaping products, including smart vapes with video games and Bluetooth connectivity, are a menace to public health overall and adolescent health in particular. These illegal products are inherently unregulated and, without rules, the potential for industry malfeasance is vast. Manufacturers can devise myriad “Easter eggs” or hidden features meant to delight young users and entice new users by exploiting developmental tendencies of adolescents, including curiosity and high interest in novelty. “Smart features” could be programmed to remind youths to continually handle their vaping device, reminding them and, in some cases, triggering them to consume nicotine through behavioral reinforcement. For example, a smart vape could easily track use patterns and buzz or otherwise remind a user to take another hit after a preset amount of time has passed. Such programming would hasten the development of addiction among new users; the constant triggering could also make it nearly impossible for an addicted user to quit.