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Vapers may think twice before taking another puff after learning of a new study revealing e-cigarettes’ power to produce “slime cloaks” in users’ mouths.

Though the vapers involved in the study were in their early 20s and healthy, the study also warned that "at the molecular level, they were living life on the edge."

A study, published on May 27 in the research magazine Science Advances, showed how e-cigarettes can place stress on the oral microbiome and create an environment resembling a gum disease called periodontitis. While the effect of e-cigarettes on the respiratory system has received a lot of attention, the Ohio State University researchers say their study offers some of the earliest experimental evidence on e-cigarettes’ toll on oral microbial ecosystems.

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Senior author Purnima Kumar, professor at Ohio State’s College of Dentistry, told Inverse that oral bacteria coat themselves in a slime layer when exposed to vapor. While the “slime cloak” presents a challenge for healthy bacteria in attaching to the colony, it remains vulnerable to pathogenic characters, the outlet wrote.

“Most importantly, these changes happen within three to 12 months of vaping,” Kumar told Inverse. “This is the fastest change [to the oral microbiome] to a human behavior that we have observed so far, [including] diet, antibiotic use, smoking [and] hookah."

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Long-term consequences are unclear at this point because the findings are so new.

The researchers conducted the study by collecting plaque samples just below the gums in a group of smokers, nonsmokers, former smokers who switched to e-cigarettes and dual-users.

The study revealed 284 genes in vapers that were enriched, which signaled oral bacteria had entered a stress-response mode and created the slime layer. Researchers also reported increased levels of inflammatory cytokines, which also entails a bodily immune-response.

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Kumar explained the inflammatory pathways activated among smokers and vapers differed, meaning vapers could see different consequences from the inflammation.

The team pointed to two sugar alcohols, glycerol and propylene glycol, that may be the drivers of the changes in e-cigarette users’ mouths. Researchers also found the films continued to spread in the absence of nicotine.

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According to the study, 6 percent of Americans (including 3 million high school students) use e-cigarettes. The newly discovered changes in vapers’ oral microbiomes, not to mention previous reports of vaping-related fatalities and lung injuries, could be reason for alarm over additional health consequences to come.