smokeless tobacco diseases Figure 6 from Health effects of Smokeless tobacco keratosis in oral

this may be consistent with an efficient transfer of more nicotine to the lungs and a rapid rise of nicotine absorption in the plasma

So, people got inventive

Even though cigar smoke is held in the mouth rather than inhaled into the lungs, nicotine is heavily absorbed directly through your oral mucosa lining

Digoxin Rationale: Older persons are particularly susceptible to the buildup of cardiac glycosides, such as digoxin or digitoxin (medications derived from digitalis), to a toxic level in their systems

Teach your children how to wash their hands properly using soap and water or to use an alcohol-based hand sanitizer if there is no soap and water available

The organization also estimates that about 700 million children around the world inhale air that is contaminated with tobacco smoke (Heffernan, 2016)