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Mechanisms Nicotine is a well-established respiratory irritant 58 , but other chemicals in e-cigarettes (e.g., diacetyl 59 , propylene glycol, carbon monoxide, and formaldehyde 60 ) also have detrimental effects for lung function including respiratory volume 61

Overall, 39 of the trials were judged to have a high risk of bias, said Braznell, including selective reporting of results

That 16-page report was redlined by folks in the FDA