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Mutual Reinforcement : Both substances influence dopamine release, potentially reinforcing each others effects and increasing the likelihood of co-use

E-cigarette chemicals present significant health risks: Respiratory impact: Causes lung irritation, coughing, wheezing, and increased asthma attacks

The 2016 revised statement on e-cigarettes by the US Flavoring and Extract Manufacturers Association about these chemicals (which have been safety assessed for use in foods and beverages, but not for inhalation) is further cause for concern: The manufacturers and marketers of e-cigarettes and all other flavored tobacco products, and flavor manufacturers and marketers, should not represent or suggest that the flavor ingredients used in these products are safe because they have FEMA GRASTM status for use in food because such statements are false and misleading

Nicaragua has grown to be a dominant force in the cigar world, and the same could be said for their lighters