Some ghouls have embraced the phrase, such as those in Set's Zombies gang. Those bigoted towards ghouls use the two phrases interchangeably, stating that ghouls should be killed before the 'go zombie' due to radiation destroying their brains. The phrase is also used to threaten ghouls. Wooz explains the difference between ghouls and zombies, in that zombies are a 'type of undead with no free will' and that despite the two sharing physical characteristics, ghouls demonstrate the ability to reason and act on their own recognizance.

The term is also used in other parts of the post-War country, such as in the Washington, D.C. Others inhabitants in the area comment about zombies in a derogatory way, including Calder, Viola, and Zark. Ghouls worship and stand guard at the Cathedral, while human members of the religion comment that zombies are a 'disgrace to God' and that they are utilized as slave labor and as soldiers.

Often used disparagingly, ghouls will correct inquiries, noting that they are not zombies, and just as human as anyone else.