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A study released by the North Carolina Department of Health and Human Services showed that within the past year, use of e-cigarettes increased among high-school-age youths by 78%, and among middle schoolers by 48%

These effects have been corroborated in both ambulatory monitoring studies showing elevated daytime blood pressures in smokers, and experimental studies demonstrating nicotine induced endothelial dysfunction and altered vascular reactivity (25, 26)

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