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It is characterized by impaired endothelium-mediated vasodilation, reduced nitric oxide levels, increased inflammatory response, and a prothrombotic state 4

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"Electronic cigarette vapour does not contain smoke, which is why vaping is much less harmful," said Deborah Arnott, ASH's chief executive

= 10.4 years)

46 The National Youth Tobacco Survey conducted in 2016 found that for students who reported using e-cigarettes that year, 39% stated their reason for starting to use was use by a friend or family member. 47 In other words, over a third of high school students claimed they started to use e-cigarettes because someone in their family or friend group did