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Dopamine is a hormone associated with feelings of pleasure and reward, so when alcohol and nicotine are consumed together, they can increase each others effects on these reward pathways which can intensify the pleasurable sensations experienced

But ultimately, its enforcement, or the lack of it, thats allowed this market to develop the way it has. Theres no federal regulation unless a particular state steps in, says Bricken

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Smoking also induces vascular and nutritional deficiencies that affect nerve function