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The results of this study highlight the need for greater oversight and enforcement of online tobacco retailers. Key findings include: 1% of buyers had their IDs scanned 81% of deliveries were made via the USPS 9% arrived via couriers with policies restricting shipping tobacco, including: 4.0% via UPS, 3.0% via FedEx 3.0% and 1.8% via DHL 78% of buyers reported no interaction with delivery personnel 15% of buyers spoke with delivery personnel but did not have their IDs checked 6% of buyers had their IDs checked but not scanned Online sales of e-cigarettes are the largest and fastest growing sector of the tobacco

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Middle ear infections can also cause a hole (perforation) in the eardrum or spread to nearby areas, such as the mastoid bone