Vape causes the least long-term lung damage of the four. Combustion in joints, cigarettes, and cigars produces tar, carbon monoxide, and many carcinogens linked to chronic bronchitis, inflammation, hyperinflation, COPD risk, and cancer. Cigarettes show the strongest evidence of severe lasting harm from typical heavy use. Cigars carry similar toxins with risks varying by inhalation depth and frequency. Cannabis joints irritate airways and alter lung function but lack consistent links to irreversible COPD or cancer at moderate levels. Vaping avoids combustion, delivering far fewer of those toxins (per National Academies and comparative studies), though it is not risk-free and long-term data remain limited.
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