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In addition, inhaling substances into the lungs via vaping can cause scarring and other lung problems, just as traditional smoking can

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doi: 10.1016/j.fct.2018.03.025

HEALTH EFFECTS Tobacco use is associated with heart disease and cancer, the two leading causes of death among American Indian and Alaskan Native adults

Accordingly, we separated smokers into categories of light and heavy tobacco consumption smokers by the median pack-years (median = 21), and some researchers have found that a tobacco consumption more than 20 pack-years could significantly increase the risk of certain diseases ( The exclusion criteria for all groups were: (1) age of less than 18 years