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Its also important to note that smokeless tobacco or electronic vapes are not a healthy substitution for cigarettes

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What makes e-cigarettes so harmful to the heart and lungs is not just nicotine, said senior author Florian Rader, MD, MSc, medical director of the Human Physiology Laboratory and assistant director of the Non-Invasive Laboratory at the Smidt Heart Institute

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nonetheless, the presence of nicotine could somehow perpetuate platelet functional changes in a dose-dependent manner, making its role in electronic cigarette-induced damage even more inconclusive.81 Another link to cellular dysfunction induced by vaping was provided by a study analysing the response of liver Kupffer cells both to classic and electronic cigarette extracts exposure