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MMP-9 activity has been previously shown to be elevated in the lungs and upper airways of vapers 13,21 , and MMP-9 is known to play an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD) 22

Because the association between e-cigarette use and smoking cessation behavior remains unclear, more empirical research is warranted to help form evidence-based regulatory policy on e-cigarettes use for adolescents

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