The biggest threat to lung health in the current era is vaping. Shanda H. Blackmon, MD, MPH, moderates a discussion about the changing landscape of tobacco use, which includes vaping as the new gateway to smoking. She and colleagues, J. Robert Headrick, MD, MBA, Matthew A. Steliga, MD, and Keith S. Naunheim, MD, describe the “terrifying” statistics about vaping, why patients are oftentimes afraid to seek help, the use of graphics warnings, and why bringing smoking cessation resources to patients may become more necessary.