Vaping

To the Editor Dr Winickoff and colleagues' Insights article notes that "discreet, easily concealed vaping devices, with concentrated nicotine and youth-friendly features and flavors, present new clinical challenges." 1 We add that so-called smart vapes present additional challenges.At prices similar to other e-cigarettes, these e-cigarettes with digital displays can include animations that display when puffing, built-in games, reward systems for vaping such as points and rankings, touchscreens, photo wallpapers, and Bluetooth connectivity. 2Multiple e-cigarette brands with smart vape features are currently illegally marketed in the US without US Food and Drug Administration (FDA) authorization.These products are rapidly gaining market share, according to retail scanner data.Specifically, the smart vape brands Geek Bar Pulse and Raz, which debuted in October 2023, emerged as the third and sixth top-selling e-cigarettes as of June 2024. 3art vapes are gaining popularity among youth.Among US middle and high school students reporting past-month e-cigarette use in 2024, 5.8%-an estimated 90 000 youthwrote in that they use Geek Bar. 4 As a write-in response, this is likely an underestimate; Geek Bar Pulse became popular in the brief span between survey finalization and the January to May survey fielding period.E-cigarette use among US youth reached a 10-year low in 2024, 4 likely owing to concerted multisector public health efforts.Young people also deserve credit for resisting or quitting vaping.But high-tech e-cigarettes that gamify use of an addictive substance could undermine recent progress.These inexpensive, appealingly flavored products intersect nicotine addiction with 2 potentially addicting behaviors-screen use and gaming.