My Patient Vapes. How Should I Counsel Him?

Charles P. Vega, MD


October 17, 2022

To focus on challenges in primary care, this month I'm presenting the case of a healthy young man who vapes on a daily basis. I'll tell you what I plan to do, but I'm most interested in crowdsourcing a response from all of you to collectively determine best practice. So please answer the polling question and contribute your thoughts in the comments, whether you agree or disagree with my approach.

The e-Cigarette Using Patient

Eusebio is a 20-year-old man brought in by his mother for a wellness exam. He tells you, "My mom wants me to get a checkup every year and then get a lollipop. She wants me to stay 8 years old forever." Eusebio has no complaints and no chronic illnesses, past surgical history, or medications. He needs an influenza vaccine and COVID-19 vaccine booster today; otherwise, he is up-to-date on his vaccinations.

Eusebio is entering his junior year of college and is majoring in music. He has played piano and bass for "as long as I can remember" and plays in two bands currently. He wants to continue to play music professionally after he gets his degree.

Eusebio reports having several alcoholic drinks on the weekends. He denies any other drug use. He reports vaping after class every day. He says, "I smoked cigarettes in high school but gave that up. Vaping was easier to get hold of, and I thought it was better for me than cigarettes. Is that right?"

The rest of his social history is unremarkable, as is his physical exam. You order his influenza and COVID-19 vaccines but also decide to spend some time discussing his use of e-cigarettes.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.