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An earlier study from 2016 showed similar results, testing on gum tissue cultures, and found that flavoured e-cigarette aerosol caused more oxidative stress and inflammation than unflavoured e-cig aerosol (5), supporting the results from the 2020 study

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This might be due to selection bias because psoriasis patients enrolled in this study were all patients with moderate to severe psoriasis, who tended to have higher scores of BSA and PASI, even without tobacco smoking, which diminished the association between tobacco smoking and psoriasis severity