effects of chewing tobacco on health CDC - Fact Sheet - Smokeless Tobacco: How Tobacco Use Affects Oral

The study found that participants who had used e-cigarettes in the past were 21 percent more likely to develop a respiratory disease, and those who were current e-cigarette users had a 43 percent increased risk

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When asked where they obtained their e-cigarettes, 45.31% of surveyed users said they got them from friends or acquaintances, 23.93% purchased them online, 30.76% bought them from tobacco shops, and 22.65% got them from "other" sources (various shopping centers)

This is primarily due to the adverse effects of the leaves and deeper inhalation