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Although its not proven, some have speculated that this masking can sometimes lead users to take more profound or more frequent puffs than they otherwise would, which might slightly increase the risk of throat irritation, especially in novice users

Sources: JAMA Neurology, Smoking and Risk of Alzheimers Disease JAMA Neurology The Lancet Neurology, Cigarette Smoking and Dementia Risk The Lancet Alzheimers Society, Smoking and Dementia Alzheimers Society Frontiers in Aging Neuroscience, Impact of Smoking on Cognitive Function Frontiers in Aging Neuroscience