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It should, however, be mentioned that dual users (who smoke and vape) have a risk of cardiovascular disease of the same order as that of smokers, which indicates that the residual exposure to tobacco toxins, even if it is slightly reduced in these people, remains harmful and sufficient to damage the heart and blood vessels

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Studies of this smoking-thrombolysis paradox have shown that TS use is associated with reduced infarct growth, as well as a higher rate of recanalization and reperfusion in TS users treated with IV r-tPA, following ischemic stroke (Kufner et al., 2013)