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Nicotine stomatitis is often considered a form of heat- or chemical-related keratosis, which is a thickening of the skin

While the inflammatory response may normalize shortly after cessation, changes in adaptive immunity, particularly T cell responses, can persist for 10 to 15 years

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[13] Metal and silicate particles, some of which are at higher levels than in traditional cigarettes, have been detected in e-cigarette aerosol, resulting from degradation from the metal coil used to heat the solution