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Nicotine has known pathological effects, mainly related to the excessive release of catecholamines, endothelial dysregulation and increased insulin resistance.90 Nicotine in electronic cigarettes has been shown to increase heart rate after overnight abstinence.91 Regarding lipid metabolism, nicotine in electronic cigarettes has been shown to increase the amount of circulating saturated fatty acids, decreasing the content of unsaturated fatty acids and inducing insulin resistance

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This is typically why most doctors recommend weaning off nicotine slowly with nicotine replacement therapy to increase the chances of long-term success

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