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Notably, some of these effects appear even without nicotine present, which means the flavouring compounds themselves carry the risk

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Dual users were also more likely to have a history of arrhythmia (17.8 percent) compared to cigarette-only users (14.2 percent)

There may also be significant swelling

Although there were no significant differences in monocytes and lymphocytes between smokers and non-smokers in the current and previous studies 52,55 , except for a reduction in the number of eosinophils, we observed a significant increase in TNF-, IL-2, IL-4, IL-6 and IL-10