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Although nicotine content may be comparatively lower in ST products than the smoked form, ST tend to be abused more frequently for reasons such as false perceptions of being safer than smoked tobacco, more inconspicuous form of consumption and more widespread restrictions of smoking in public places (Sharma et al., 2015, Siddiqi et al., 2017) and significant levels of nicotine can enter systemic circulation (Saleheen et al., 2014, Li et al., 2018)

If symptoms like persistent headaches, dizziness, limb weakness, numbness, or chronic spine pain appear, immediate neurological evaluation is advised