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If in the assessment step a health care professional uncovers a smoker who is unwilling to quit, the American College of Chest Physicians recommends that the professional who is counseling the smoker work jointly with the patient to identify and define what is called the five Rs: Relevance, Risk, Rewards, Roadblocks, and Repetition

A 2016 review published in the American Journal of Respiratory and Critical Care Medicine found that e-cigarettes, like traditional cigarettes, are likely to be harmful to fetal lung development

A national survey found that the majority of youth ages 12-17 reported that the first tobacco product they tried was flavored (88.7% of youth who ever smoked hookah, 81% of youth who ever used an e-cigarette, 65.4% of youth who ever smoked a cigar, and 50.1% of youth who ever smoked a cigarette)