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But how safe is this occasional indulgence

"Intelligence received from inspectors, investigators, and law enforcement officers working in the field indicates that the smuggling of untaxed tobacco and [Electronic Nicotine Delivery Systems] products remains a challenge." At $3.51 per pack, Massachusetts isn't even the most heavily taxed state when it comes to cigarettes, nor does it have the largest black market in tobacco products

Chin Med J 135:584590 Xiang T, Fei R, Wang Z, Shen Z, Qian J, Chen W (2016) Nicotine enhances invasion and metastasis of human colorectal cancer cells through the nicotinic acetylcholine receptor downstream p38 MAPK signaling pathway

The current review identified 1 study 90 of middle-aged men at high risk for cardiorespiratory disease that found lower (although not statistically significant) total mortality, fatal coronary disease, and lung cancer death at 20 years of follow-up in participants who received advice from medical practitioners