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thus, wrinkles and fine lines appear prematurely Gum disease, tooth discoloration, and bad breath: tobacco yellows teeth, increases the risk of tooth loss, and weakens the gums Deterioration of the oral and nasal mucosa, lips, and tongue, as well as taste buds, vocal cords, and salivary glands Deficiencies in vitamins B and C Damage to the cerebral arteries (effects on memory, vision, and hearing) Damage to the esophagus and stomach A 20-fold increased risk of lung cancer when smoking is combined with prolonged exposure to radon

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A 2026 study published in Frontiers in Public Health found that dual users smoked a median of 20 cigarettes per day and also took a median of 195 e-cigarette puffs per day

J Abnorm Psychol 112 : 497507