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Chlorophyll a fluorescence (ChlF) analysis revealed impaired PSII photochemistry, as evidenced by reduced fluorescence yields and a significant decrease in fluorescence intensity at higher smoke exposures

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This is because the smoke is in large particles that are too big for your lungs to absorb all at once

However, in vitro and animal studies dont necessarily predict what will happen in humans

Additionally, it is well-documented that CSE elicits distinct cellular and molecular effects compared to CS in animal models 17

Smoking has been closely linked to the development and worsening of GERD, a condition where stomach acid frequently flows back into the esophagus