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Associations with other nicotine product use were strong, with current use of other non-ONP tobacco or nicotine products showing the largest association (APR = 21.05, 95% CI 13.0333.99), followed by current cigarette smoking (APR = 2.04, 1.123.71), and current e-cigarette use (APR = 1.91, 0.814.50)

Many studies have shown that there is a higher prevalence of this disease, increased progression and worse response to treatment in patients who are active smokers

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When vaping, e-cigarette users inhale toxic liquids and inhalable pollutants that enter the body and impact most organs , especially those in the upper airway