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Other factors that can increase the risk of oral leukoplakia include alcohol use, long-term irritation, fungal infections such as oral thrush, damage due to dental treatments, bacterial infections, sexually transmitted diseases like syphilis, a lack of essential nutrients, viral infections, hormonal imbalances, and exposure to ultraviolet light

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Research shows that aerosol from e-cigarettes can contain harmful chemicals, including nicotine, ultra-fine particles that can be inhaled deep into the lungs, flavoring such as diacetyl, which is a chemical linked to a serious lung disease, she said

Pharmacol Ther

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Then you have the economic damage that isnt being measured