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however, it may be a concern due to the appearance and the frequent unpleasant mouth odor from the trapping of particles in the tongue

The Mayo Clinic identifies an assortment of horrors associated with chewing tobacco, whether it is packaged in the form of leaves, paste or twists: Tooth decay, gum disease, high blood pressure, oral and nonoral cancers

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Furthermore, nicotine and chemical constituents of both TS and e-cigs have been reported to interact with the liver cytochrome P450 (CYP-P450) enzymes and affect plasma drug levels of certain central nervous system (CNS) drugs (Zevin and Benowitz 1999

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