When tobacco is kept in the cheek or under the lip for long periods, the soft tissues are continuously soaked in toxins, leading to a condition called Oral Submucous Fibrosis (OSMF), a precursor to cancer
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Peer influence remains a dominant factor, with initiation often occurring in social contexts where vaping is normalised, particularly through friends, siblings, and informal peer networks within schools [38, 39]
It has been calculated that for every one million smokers who switch from cigarettes to electronic ones, which deliver nicotine but do not contain tobacco, then 6,000 premature deaths would be prevented every year
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