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Sadly, like other tobacco products, the main ingredients in betel quid are known carcinogens according to the International Agency for Research on Cancer

I do value the importance of smoking in epilepsy pathogenesis and pharmacotherapy and would like the authors to add another question: the impact of passive smoking during pregnancy on thr incidence of epilepsy development in offsprings via retrospective evaluation

Depending on the cause and source, the liable parties may include the makers of e-cigarette companies that produce or distribute Diacetyl

Misrepresentation of the vape particulates There is an extensive literature of publicly funded studies (from universities, public health and regulatory agencies, the WHO, etc) on exhaled vape aerosol (identified as second hand aerosol)