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The American Academy of Pediatrics has linked high caffeine intake in adolescents to anxiety, irregular heart rhythms, and chronic sleep deprivation, which is an independent risk factor for cardiovascular disease Combined use compounds cardiovascular stress: When vaping and energy drink consumption overlap, as they frequently do, the cumulative stimulant load places added strain on the heart

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Many people use nicotine (cigarettes or vapes) to "calm their nerves." While the immediate effect might feel relaxing, nicotine is actually a powerful stimulant that can worsen anxiety long-term

A spokesperson for Philip Morris International told BI in a statement that "ZYN is designed as a better alternative for adults aged 21 or older who are currently using nicotine products and wish to continue using nicotine