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In an editorial for the Journal of the American Medical Association published in March, Glantz writes that e-cigarettes may increase risk of heart attack, stroke, and respiratory disease, perhaps because of the toxicants that e-cigarettes aerosol delivery introduces

First cultivated by Choctaw and Chickasaw Indians more than 400 years ago, the Perique tradition has been carried down through generations

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While not much is known about the long-term risks, and though closed systems appear to be less risky than open systems, the best advice may be to educate adolescents on the risks of both systems and encourage them not to pick up the habit in the first place