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Conversely, Staudt et al., in a trial with healthy non-smoking subjects exposed to both nicotine-containing and nicotine-free e-cigarettes, noted genetic changes in small airway epithelial cells, alveolar macrophages, and lower airway mononuclear phagocytes after short exposure to EC aerosols

This is mainly because alcohol and HBV/HCV infections synergistically contribute to liver damage, exacerbating inflammation and fibrosis, which accelerates progression to cirrhosis and increases liver cancer risk [47]

"Anatomy of a Joint: Comparing Self-Reported and Actual Dose of Cannabis and Tobacco in a Joint, and How These Are Influenced by Controlled Acute Administration"