Inhaled e-cig vapor increases levels of ROS. This increase in ROS affects the buffering capacity of antioxidants, inducing oxidative stress85. More specifically, within endothelial cells, NO is the primary antioxidant85. When NO reacts with superoxide anion, free radicals form to disrupt proteins within the endothelium85, leading to endothelial dysfunction and platelet aggregation, further predisposing individuals to thrombosis, and decreased blood flow beyond the site of platelet aggregation. Created with BioRender.com.