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Studies have shown that a characteristic shift in autonomic balance, often marked by heightened sympathetic tone and blunted parasympathetic control [42, 43] Interestingly other studies have reported that physiologically, this imbalance manifests as increases in heart rate, blood pressure, and myocardial contractility, alongside reduced heart rate variability (an well-known marker of impaired vagal regulation vis acute nicotine exposure cigarettes, ecigs, oral nicotine)

This finding is consistent with the known ability of CS to induce a state of chronic oxidative stress through the production of ROS 18

The indigenous peoples of the Americas are known to have used the tobacco plants in many ways, including for religious and medicinal purposes