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Conversely, Staudt et al., in a trial with healthy non-smoking subjects exposed to both nicotine-containing and nicotine-free e-cigarettes, noted genetic changes in small airway epithelial cells, alveolar macrophages, and lower airway mononuclear phagocytes after short exposure to EC aerosols

When inhaled, these metals can cause coughing, wheezing, chest tightness, or shortness of breath