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More acute clinical reports have further underscored vapings potential for harm: in 2019, an outbreak of e-cigarette or vaping-associated acute lung injury (EVALI) in the US resulted in over 2,800 hospitalizations and 68 confirmed deaths, predominantly in adolescents and young adults (14)

These findings align with broader evidence on , where nicotine exposure is treated as a modifiable risk factor rather than a primary cause

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