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While more research is needed in order to establish a concrete connection between this effect and the development of smoking-related diseases, evidence suggests that changes to the bacterial populations in smokers mouths could increase their susceptibility to the toxic effects of tobacco smoke

Recent data show that teens are now also 16 times more likely to use e-cigarettes than 25-34 year-olds

Postscript, while the young adults said they rolled their own cigarettes, what was unclear was whether they did so exclusively or for long periods and whether or not they had simply tried RYO once or twice