There are trace components of tobacco-specific nitrosamines and things that are harmful, but it's still much, much lower than chewing tobacco, for example
The conditions
comparing the acute impact of tobacco versus e-cigarettes with equivalent nicotine content, found that within 5 min of smoking or vaping, both tobacco smokers and healthy individuals exhibited a statistically significant increase in sCD40L, sP-selectin, and platelet aggregation levels in a single-blind crossover trial (40)
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These leaves are fermented and aged to develop their unique flavors and characteristics
Its hard to blame Elvis for this, however