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While currently there are no studies that directly examine lung damage from inhaling aerosolized vitamin E acetate, there have been several proposed mechanisms

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Many studies concluded that AHI is deteriorated or affected in a dose-dependent manner with smoking, even after adjusting for covariates [5,7,79,80,81,82,83], while in other studies AHI seems not to be related to smoking [84,85,86,87,88,89,90,91]

In some settings, nicotine or smoke-conditioned environments may also push macrophages toward dysfunctional immunosuppressive or M2-like states