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This can happen because taking high quantities of stimulants can cause someone to lose touch with reality

[I]t is appropriate to consider potential hazards of e-cigarettes, the authors wrote, but they emphasized that this analysis should be carried out relative to the impacts of smoking: [A]s smoking cessation is associated with a reduction in respiratory symptoms in people with respiratory disease, many smokers who switch to an e-cigarette are likely to experience improvements in respiratory symptoms

With adequate data (both safety, effectiveness and consumer label comprehension), some drugs, including several NRTs, have been able to make the Rx-to-OTC switch

This means that Medicare and commercial insurance carriers must provide coverage for smoking cessation counseling and interventions