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Common trees used to make chew sticks include: Salvadora persica (the "toothbrush tree") popular in the Middle East and parts of Africa Licorice bush known for its naturally sweet taste and antibacterial compounds Neem tree widely used in India and parts of West Africa African bitterleaf traditional in rural African communities Africa Imports sources chew sticks from the licorice bush, which gives them a pleasant, mildly sweet flavor

However, there have been situations where people who begin smoking with vapes eventually try cigarettes

Despite these limitations, the direction of the evidence has not substantially changed in recent years, but rather has been reinforced