Vapes and e-cigarettes promised harm reduction — but the evidence tells a different story. This 2025 umbrella review from the World Health Organization, published in *BMJ Open*, consolidates 69 systematic reviews covering more than a decade of research on electronic nicotine delivery systems (ENDS). The verdict is clear: ENDS harm multiple organ systems. Cardiovascular data show elevated heart rate, blood pressure, and endothelial dysfunction — precursors to atherosclerosis and stroke. Meta-analyses indicate a 25 percent higher stroke risk among users. Respiratory studies reveal increased asthma and COPD rates and a growing list of vaping-related lung injuries. Oral and reproductive health impacts include gum disease, cracked teeth, reduced fertility, and lower breastfeeding rates. Adolescents who vape show higher rates of depression and suicidal thoughts, while accidental poisonings and device explosions pose immediate physical risks. Mechanistically, oxidative stress, inflammation, and vascular dysfunction drive much of the observed damage. The authors conclude that ENDS are not safe substitutes but active health hazards. They urge stronger regulation — including flavor bans, age limits, and transparent reporting — alongside public education to counter industry misinformation. Reducing youth exposure is paramount. Ultimately, vaping is not a safer form of smoking; it’s a new front in the same battle. Awareness and regulation remain the best defense against an avoidable epidemic. Produced by Cognivault — insight, intelligence, and innovation made clear.