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"The range, appearance, and accessibility of tobacco products has changed significantly in recent years," said Dr Jamie Hartmann-Boyce, Senior Researcher and Managing Editor in the Cochrane Tobacco Addiction Group, which is based in Oxford University's Nuffield Department of Primary Care Health Sciences

Enhanced angiogenesis has also been of concern, although its relevance to human cardiovascular disease has not yet been established

Nicotine, a component of cigarettes, weakens the lower esophageal sphincter, a muscle crucial for preventing stomach acid from regurgitating

In vitro studies have also shown that exposure to vaporized e-liquid containing flavor additives resulted in an increase in DNA damage, oxidative stress [48], and cell death [49] in epithelial cells

[14] In 2024, the Massachusetts Supreme Judicial Court upheld a 2020 bylaw passed by the town of Brookline, which enforces a lifetime ban on the sale of tobacco products to anyone born on or after January 1, 2000, the first of its kind in the United States