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(ACOG 2017

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A cross-sectional study revealed a twofold increase in the nicotine dependency index among e-cigarette users, and a 1.5-fold increase among dual e-cigarette and traditional cigarette smokers 49

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In addition, nicotine was found to be the primary contributor to elevations in protease activity in isolated human neutrophils and macrophages, when compared to e-liquid solvents [22]

...he smoked because most people around him did (including his own biological family members)