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Amy Kimball, pediatrician with Health Trust Physicians Clinic in Winterset, says social media has created new opportunities for tobacco products to be advertised, especially to younger Iowans: "So much of the advertising is targeted, especially with our young people

By contrast, scientific studies show that in the aerosol of a heated tobacco product water and glycerine form approximately 90% of the aerosol mass, there are no solid particles and the levels of toxicants are reduced on average by 90% compared to cigarette smoke

Although nicotine is the main chemical that smokers are addicted to, it has relatively minor health effects in the low concentrations used in vaping (except in pregnancy)

Further occasional issues were microhematuria, urinary retention, testicular cysts, bilateral mobile testis, pelvic varicocele, cryptorchidism, and bladder diverticula and hypoplasia (Additional Table 1)