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Chronic nicotine use also leads to changes in multiple neurotransmitter systems, particularly increasing dopamine release in the reward pathway and altering nicotinic acetylcholine receptors (nAChRs)

"Smoking is uniquely lethal, yet most of the concern is about young people vaping." The researchers supported a government proposal to raise the smoking age, which would mean a child turning 14 this year could never legally buy cigarettes

Unfortunately with lung cancer, there are no early warning signals

Further research, including direct comparisons with non-smokers and more detailed toxicological assessment, is needed to clarify the reproductive risks of E-cigarettes and guide fertility counseling