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Introduction Adolescent vaping has risen sharply in recent years, raising national concern (Brose et al. 2024; ASH UK). Potentially harmful e-liquid additives such as vitamin E acetate, commonly used in cannabis vaping, have been linked to acute lung injuries, first reported in the United States in 2019 (Soto et al. Ann Thorac Med 2023;18:1–9). Lung function is a vital diagnostic tool for detecting lung damage, but the data regarding the impact of vaping, particularly among adolescents, is limited. This systematic review evaluates the effects of vaping-associated lung injury or illness in this population.Methods MEDLINE and PubMed were searched using the modified population, intervention, comparison and outcome (PICO) framework. A total of 32 articles were identified; 11 studies met the inclusion criteria (published between 2019 and 2024). Studies were appraised using the Critical Appraisal Skill Programme (CASP) checklist for cross-sectional studies. Statistical analysis was performed using SPSS (v. 27) and Excel. Means and Standard Deviation (SD) were reported for age and lung function. A one-way ANOVA assessed a significant age difference between studies, with significance considered p<0.05.Results Across 11 studies, 86 patients (69% male and 31% females, mean age 16.6 ± 0.6 years) with vaping-related lung injury were identified. One-way ANOVA showed no statistically significant age differences (p=0.77). 6 studies confirmed tetrahydrocannabinol (THC) use in all patients, while others showed detection rates between 58.3%-90.9%. Lung function data were inconsistently reported, with few studies reporting standard reference values. Standard deviations varied across lung function values (table 1). The Forced Expiratory Volume in 1 second (FEV1) and Forced Vital Capacity (FVC) often improved with follow-up, but diffusion capacity (DLCO) remained persistently reduced. CASP quality scores ranged from 40.9%-77.3%, reflecting mixed study quality.Conclusions Adolescents with vaping-related lung injury or illness may continue to experience gas exchange impairment despite treatment, suggesting vulnerability, particularly as the lungs are still developing. No controlled trials exist in this population; however, the growing prevalence of vapers highlights an urgent need for further robust research.Abstract P11 Table 1FEV1- forced expiratory volume in 1 second, FVC- forced vital capacity, DLCO- diffusion capacity for carbon monoxide, TLC- total lung capacity