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For both men and women, the risk of having a heart attack increases with the number of cigarettes smoked

The extent of damage rose in proportion to the number of joints smoked

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However, with federal regulation of e-cigarettes in place and an uncertain future as many remain under premarket review, some vape shops are now shifting to smoke shops (that sell both vape products and other tobacco products and accessories), diversifying their offerings to include a variety of tobacco products and (un- or under-regulated) cannabis-based products as well as kratom, as well as a growing their online retail segment, which can undermine federal, state and local restrictions on product sales in the retail environment, including youth access