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Moodiness or outbursts of anger are also frequent signs of addiction

Besides the confirmatory evidence (a person actually smoking a cigarette in public view), nicotine-stained fingers and teeth, the characteristic smell of smoke-impregnated clothing and household items, the chronic "smokers cough," the gravelly voice, and often the visible pack of cigarettes and lighter in a person's pocket or purse are signs and symptoms that a person smokes

However, a more recent study has described impaired endothelial function even after a single nicotine-free ENDS session that was also accompanied by increased inflammatory mediators (i.e., serum CRP, plasma HMGB1) and oxidative stress [117]

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