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Tob Control 2015;24(Suppl 2):ii42-ii49

The absence of combustion in smoke-free alternatives has the potential to significantly reduce the levels of harmful chemicals generated and inhaled, which should however be scientifically demonstrated on a case-by-case basis

Cigarette smoke (CS) is an established risk factor for COPD, and the oxidative stress caused by CS is related to various mechanisms that lead to cell senescence and to the senescence-related secretory phenotype (SASP) [14]

Study selection All articles identified via the literature search were exported to Covidence (Veritas Health Innovation Ltd., Melbourne, Australia), a systematic review management software

This involves the use of the tongue to push out the smoke, without actually "blowing" it out