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[54] The inhaled substances trigger chemical reactions in nerve endings in the brain due to being similar to naturally occurring substances such as endorphins and dopamine, which are associated with sensations of pleasure

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[DOI] [PubMed] [Google Scholar] 13.Cesar-Neto JB, Duarte PM, de Oliveira MC, Casati MZ, Tambeli CH, Parada CA, Sallum EA, Nociti FH., Jr Smoking modulates interferon-gamma expression in the gingival tissue of patients with chronic periodontitis

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Still, since its a relatively recent practice, the long-term effects are not that clear