PMID 31671080
Naturally, you don't feel sleepy when you're overstimulated
A study by Scientific Reports found that heated tobacco exposure led to fewer inflammatory markers in lung cells when compared to cigarette smoke [20]
"In order for the profession to incorporate smoking cessation counseling and therapy into their practices more widely, there is a need for formal training on cessation strategies, access to cessation resources and reimbursement for time and effort." Awareness about medical benefits for smoking cessation counseling and treatment and surgical protocols for current smokers, vapers and smokeless tobacco product users varied among survey participants
second, note the precipitous decline in acreage and production during the 1920s and 1930s, which was caused by the effects of the Great Depression and the African-American exodus from the South, which in turn triggered the federal government's allotments (controlling acres planted), auction systems, and price supports
Some do it as a way to stop smoking, while others take it up recreationally on its own