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In fact, sleep disturbances are a frequently reported side effect among long-term nicotine gum users in the UK

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The College of Dental Hygienists of Ontario cites a study conducted in the United States showing that tobacco use was a factor in over half of all severe gum disease cases

But even e-cigarettes labeled as being nicotine free may be a risk, El Shahawy said: Basic studies have looked at nicotine free e-cigarettes, and they will find traces of nicotine in them. Another issue is nicotine delivery, El Shahawy explained, as the amount of nicotine actually drawn into the body can differ depending on the delivery mechanism