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This type of otitis media is not treated with antibiotics

This new evidence also suggests that [because of vaping] we may see an increase in respiratory disease as youth and young adults age into midlife, including asthma, COPD, and other respiratory conditions. This work was supported by the National Heart, Lung, and Blood Institute, the US Food and Drug Administrations Center for Tobacco Products (CTP), and an American Lung Association Public Policy Research Award.

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Once the pipe is lit, smoke with small, occasional draws, keeping the smoke in your mouth rather than inhaling it into your lungs

It looks like a normal spoon