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Since PES are mostly unregulated by the FDA and clinical trials lack data and regulation, inconsistencies exist on the legal status of PES in federal and state laws in the United States and medical outcomes associated with their use

Why are they different

Because the tobacco is heated and not burned, the aerosol thats inhaled is fundamentally different in composition from cigarette smoke

Because tar coating your teeth creates a "film" of sorts, bacteria are more likely to settle there and cause tooth decay