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E-cigarettes, colloquially known as ‘vapes’, were first introduced to the UK market in 2005.1 Although e-cigarettes were initially promoted as a smoking cessation aid, an estimated 320 000 British adult ‘never smokers’ now use them.2 Accordingly, the prevalence of current vaping has increased substantially, from 1.7% (2012) to 9.1% (2023). Amid growing concerns, e-cigarettes act as a ‘gateway’ to combustible cigarettes in ‘never smokers’, and ‘current vaping’ results in symptoms previously associated with vaping-induced lung injury, the 2021 British Thoracic Society smoking cessation audit found only 6% of clinical notes contained information on vaping status compared with 79% for cigarette smoking.3–5 The UK Medicines and Healthcare Products Regulation Agency (MHRA) currently recommends documentation of vaping status as part of routine clinical practice and specifies frequency, substances vaped and devices used. We aimed to assess the quality of vaping documentation in the emergency department (ED) and acute medical unit (AMU) of our large, inner-city hospital in London, UK, and to compare this against documentation of other substances. In addition, we aimed to specifically assess documentation in patients with cardiorespiratory and gastrointestinal presentations/admissions that could be related to vaping.4