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The data from this study are based on the EPISCAN-II study in which the diagnosis of COPD was made exclusively by spirometry, without taking into account other aspects such as exposure to risk factors or the presence of respiratory symptoms.18 Being a cross-sectional design also means that the number of participants with COPD and without COPD are not well balanced and this can affect the precision of estimations

In addition, many e-cigarettes contain acrolein, which is a herbicide used to kill weeds and is linked to the development of lung cancer

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