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For example, in an analysis using primary human umbilical vein endothelial cells (HUVEC) exposed to 11 commercially-available vapours, 5 were found to be acutely cytotoxic, and only 3 of those contained nicotine [24]. In addition, 5 of the 11 vapours tested (including 4 that were cytotoxic) reduced HUVEC proliferation and one of them increased the production of intracellular reactive oxygen species (ROS) [24]. Three of the most cytotoxic vapours—with effects similar to those of conventional high-nicotine CS extracts—also caused comparable morphological changes [24]. Endothelial cell migration is an important mechanism of vascular repair than can be disrupted in smokers due to endothelial dysfunction [25, 26]. E-cigarettes are sometimes called e-cigs, vapes, vape pens, e-hookahs, and electronic nicotine delivery systems or ENDS.
A Yale study in 2019 found that, among students at three Connecticut public schools, those who used e-cigarettes were more likely to smoke regular cigarettes in the future. Most e-cigarettes have a battery, a heating element, and place to hold a liquid (such as a cartridge or pod). The e-liquid usually contains nicotine, flavorings, and other chemicals. As the user draws on the device, the battery heats the e-liquid to produce aerosol (not water vapor).
The harmful effects of CS and their deleterious consequences are both well recognised and widely investigated. However, and based on the studies carried out so far, it seems that e-cigarette consumption is less toxic than tobacco smoking. This does not necessarily mean, however, that e-cigarettes are free from hazardous effects. Indeed, studies investigating their long-term effects on human health are urgently required. In this regard, the main additional studies needed in this field are summarized in Table 3.
The prognosis depends on how much nicotine was taken and how quickly treatment was started. If a person is able to survive during the first four hours after poisoning, they’re usually likely to recover. If a person has been severely affected, they may have ongoing seizures or respiratory failure or other problems because of the damage done from low oxygen levels during the nicotine overdose event. Increased levels of nicotine or cotinine (nicotine metabolite) can be detected in urine or blood. Nicotine poisoning or overdose can also result from taking more than the recommended amount of nicotine replacement products (for example, chewing too much gum or dissolving lozenges) or taking too high of a dose of patches, inhalers or nasal sprays.
To vape is to inhale vapor created from a liquid heated up inside a device. The devices have many names—vape pens, pod mods, tanks, electronic nicotine delivery devices (ENDS), e-hookahs and e-cigarettes. Most e-cigarettes contain nicotine and their repeated use 
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