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A recent review found evidence of negative impacts on the respiratory, oral and mental health of adolescent users and reported these effects were greater for dual users than for either exclusive smokers or exclusive vapers.[4] As Figure 1 shows, dual use prevalence increased markedly between 2018 and 2021

DOI:10.3390/ijms26199687 [Google Scholar] Minagawa S, Araya J, Numata T, Nojiri S, Hara H, Yumino Y, et al

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Effects of active tobacco smoking on the prevalence of asthma-like symptoms in adolescents