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A distressed lung environment can send signals that cause inflammation in the gut, and a disrupted gut microbiome can make the lungs more susceptible to issues

A review of popular vaping misconceptions: redefining ENDS safety and usage risks Shaligram Sharma, Laura Crotty Alexander, Maureen Meister, Cassandra Ross, Joseph Hess, Kenneth Ray, Alexandra Nol, Jonathan Shannahan, Christa Wright Inhalation Toxicology 7

Age, education level, e-cigarette dependence, and use during COVID-19 were significantly associated with at least one past e-cigarette quit attempt

Therefore, e-cigarettes are safer than conventional smoking but that does not mean they are innocuous