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We propose that cigarette smoking impairs immunosuppressive function of Tregs by reducing the number of suppressive Tregs or increasing the prevalence of non-suppressive Tregs, leading to an enhanced autoimmune component in COPD pathogenesis, while increased Treg numbers may occur in some smokers under circumstances, leading to worsened respiratory infections

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The exposure of mice to E-cigarette aerosols induces bladder toxicity 28 , and bladder carcinogens have been detected in the urine of 92% of E-cigarette users consistent with the potential carcinogenic effects of both UEL and MEL preparations 29