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Immediate short-term effects of nicotine use and abuse include: Increased heart rate Increased blood pressure Increased alertness Euphoria Feelings of relaxation Congestion Ear infections Persistent cough Bad breath Heartburn Long-term effects of nicotine use and abuse include: Emphysema Chronic bronchitis Lung and mouth cancer Cancer Heart attack Stroke Diabetes Cataracts Macular degeneration Gum disease Weakened sense of taste and smell Premature aging and wrinkles Addiction Nicotine abuse can also lead to (or contribute to) psychological problems, such as: Depression Irritability Anxiety Restlessness A variety of social problems may also come as a result of nicotine abuse, including: Strained relationships Decreased productivity at work Financial insecurity Abusing tobacco products may also make it more difficult for a woman to become pregnant and can increase the risk for miscarriage, sudden infant death syndrome (SIDS), stillbirth, early delivery, and other pregnancy complications

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[19] In addition, New York City has a very diverse market with many small independent retailers and many neighboring areas without strong tobacco policies

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Furthermore, local reputation and social status varied with the quality of ones leaf