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Long-term smokers develop the characteristic set of facial changes known as smoker's face in about 8% of cases

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Research shows that nicotine in e-cigarettes increases the infiltration of inflammatory cells, including eosinophils, from the blood into the airways, stimulates the production of type 2 inflammatory cytokines such as IL-4, IL-5, and IL-13, and promotes mucin secretion, exacerbating airway inflammation and hyperresponsiveness, ultimately worsening asthma [66, 67]

Furthermore, EC and CS significantly altered oral microbiome diversity and composition, increasing Prevotellaceae and decreasing Neisseria compared to nonsmokers