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This study shows that when smokers interested in reduction are provided with an e-cigarette that has cigarette-like nicotine delivery, they are more likely to achieve significant decreases in tobacco-related toxicants, such as lower exhaled carbon monoxide levels. The researchers conducted a randomized controlled trial of 520 participants who smoked more than nine cigarettes a day, were not currently using an e-cigarette device, and were interested in reducing smoking but not quitting

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This might cause a direct cell injury or induce a variety of cellular responses through the generation of secondary metabolic reactive species (Figure 3)