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That was just one of the careful balancing acts Gungeon required, finding a happy medium between kitchen-sink design and restraint

and modifying or adding substances to e-cigarettes

One study raised some major methodological concerns, 28 five studies raised minor methodological concerns, 2326,31 and two were appraised as raising no concerns

Heating of high-intensity sweeteners (e.g., saccharin, sucralose, and glycyrrhizin) and sugar alcohols (e.g., sorbitol) also produces a range of toxic chemical compounds

Pryor WA, Stone K (1993) Oxidants in cigarette smoke

Notably, evidence from a 2024 longitudinal cohort revealed that tobacco use altered the oral microbiome, with cigarette and smokeless tobacco users exhibiting increased bacterial diversity, including a higher abundance of Firmicutes and a lower abundance of Proteobacteria compared to non-users