Tobacco Use, Electronic Nicotine Delivery Systems, and Vulnerable Populations: Current Landscape and Opportunities for Improvement.

The tobacco epidemic has claimed countless lives, caused significant morbidity, and cost billions of dollars in direct costs and lost productivity. Despite its acute vascular effects, nicotine alone has not been definitively linked to cardiovascular events. Rather, additives found in cigarettes and other tobacco products likely play a bigger role in tobacco's link to cardiovascular events. The emergence of electronic nicotine delivery systems introduces a new challenge, particularly among certain groups. Understanding the groups vulnerable to tobacco product use, identifying factors that influence this vulnerability, and examining different approaches to mitigating these factors is imperative to curbing the detrimental effects of the tobacco epidemic. Ameliorating screening and treatment efforts will require collaborative efforts that involve clinicians, health care systems, local and regional communities, government agencies, policymakers, and medical societies.