Date of this Version


Document Type

DNP Project




Background: Smoking continues to be a concerning topic among healthcare providers as it is a common risk factor among all major diseases. A new variant, in the form of electronic nicotine delivery systems (ENDS) have arrived at this mix. E-cigarettes, or vapes, have become the most often used tobacco product among young people since 2014 (Sharma et al., 2021). Statistics from the CDC show that in 2022, over 2.5 million youth, including 14.1%‡ of US middle and high schooler kids are not just experimenting with e-cigarettes, but are using them frequently, leading to an addiction that is difficult to break. The facts are as follows, 46% of high school e-cigarette users reported vaping on 20 or more days/month, 30.1% reported daily use, in total, 700,000 middle and high school students are vaping every single day (Centers for Disease Control and Prevention, 2022).

Purpose: The purpose of this author’s project is to inform users (especially teens), healthcare providers and public policymakers, about the short- and long-term hazards of vaping. In 1997, Kevin Dooley introduced the concept of a complex adaptive system (CAS), which he defined as a group of partially autonomous agents interacting in a way that is interdependent and produces system-wide patterns. His concept gives the theoretical framework for this project, where shared attitudes toward physical activity, healthy choices and self-awareness affect the health trends in any given group or community.

Methodology: In this Quality Improvement Project, an educational program was designed and delivered at the clinical site using Survey Monkey. Pretest and post-tests scores were compared and evaluated for their statistical significance. The goal was to improve provider’s knowledge regarding vaping health risks so they could have a more objective conversation with their patients.

Conclusions/Results: After completion, it was computed that 88.3% of them were willing to include this new information in their daily practice/discussions from a 16.7% that would do so rarely. Aim was to increase patient’s awareness of the risks through the provider’s knowledgeable interactions which would ensure the desired outcome for the target population, defer usage altogether. Providers obtained the tools needed to establish an interesting discussion with today's teenagers. Regrettably, e-cigarettes are still marketed as a healthier alternative to smoking, therefore creating a false sense of safety around the usage of these devices.

Discussion/Implication for practice: Longitudinal studies are still in their infancy to provide enough data to evaluate the significant health effects of their usage currently. Although it has been demonstrated that ENDS enhance the years of life gained through their influence on smoking cessation, they also disproportionately increase the years of life lost due to an increase in youth-related smoking initiation. Every significant U.S. public health authority, including the U.S. Surgeon General, the U.S. Preventive Services Task Force, the CDC, and even the FDA itself, has concluded that there is insufficient evidence to draw the conclusion that using e-cigarettes to quit smoking is an effective strategy. Therefore, it is imperative for the practitioners to have an objective discussion with their patients in order to create a knowledgeable foundation for when they are to make these decisions.