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You have to have some trauma," he said

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The side effects often only appear after there has been damage

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The increased oxidative stress induced by e-cigarettes stimulates the production of reactive oxygen species (ROS) in alveolar macrophages, causing lung epithelial damage and neutrophil influx at the injury site, leading to aggravated inflammation, mucus production, destruction of alveolar cells, and airway obstruction, potentially increasing future cardiovascular risks [53, 54]