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According to a 1976 article in the Journal of the American Dental Association, it involves holding the lighted end of a cigarette (or cigar) inside the oral cavity: "Air is drawn to the burning zone through the unlighted end of a cigarette, and smoke is expelled back through the cigarette or out through the mouth." While the smoke is not inhaled, according to the article, the ashes are swallowed
The findings are important, Middlekauff says, because they show that e-cigarette users hearts are in flight or fight mode all the time, not just when they are smoking
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