Electronic nicotine delivery systems, electronic cigarettes (e-cigarettes), or vapes are a relatively new product category, which first emerged in 2004. Emerging evidence demonstrates that e-cigarettes are less harmful than conventional cigarettes and with the legalization of e-cigarettes containing nicotine, there is improved access to e-cigarettes for current smokers, therefore allowing adults more choice around alternative methods of nicotine intake and/or tobacco cessation. Today, with the deregulation of cannabis in Canada and a majority of the United States, many smokers are also reaching for marijuana or THC (tetrahydrocannabinol) to be a part of their smoking regime. Is it true that where there is smoke there is fire? This interactive program looks at some of these most challenging patients, their most common negative sequelae due to drug use and the management of these patients with a particular focus on the dental realm. Case studies will augment the delivery of key points and a problem-based learning approach is encouraged so that each participant’s questions are addressed. Most importantly, you will learn directly applicable strategies to successfully treat these medically-complex patients on Monday morning.