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Bernhard D, Rossmann A, Wick G (2005) Metals in cigarette smoke

While most acute symptoms improve within the first few weeks to months, needing ongoing support is normal

Cancer Res 1988

Toxicant exposure is greatest among dual users..." In other words, people who smoke and vape are exposed to the highest levels of toxicants, but people who only vape are exposed to lower levels of toxicants

Other reports, such as by Kadir & Sarani (2015), indicate that some toxic effects can occur from one cigarette butt even at concentrations of one cigarette butt per 4,000 liters

Halpern-Felsher: This is a complicated question, as much more research is needed