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Supplementary material The Supplementary Material for this article can be found online at: BOP bleeding on probing CAL clinical attachment loss CASP Critical Appraisals Skills Programme COI conflict of interest COPD chronic obstructive pulmonary disease CV cardiovascular CVD cardiovascular disease DUs dual users EVALI e-cigarette- or vaping-associated lung illness FEV1 first second of forced expiration FVC forced vital capacity FET forced expiratory time GCF gingival crevicular fluid GRADE grading of recommendation assessment, development, and evaluation HDL high-density lipoprotein LDL low-density lipoprotein HNB heat-not-burn MBL marginal bone loss MFEF maximal forced expiratory flow MMP-2 matrix metalloproteinase-2 MMP-9 matrix metalloproteinase-9 NASEM National Academies of Sciences, Engineering, and Medicine PEF peak expiratory force PD probing depth PI plaque index PHAC Public Health Agency of Canada PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses RCT randomized controlled trial RBL radiographic bone loss RoB risk of bias THC tetrahydrocannabinol TSs traditional smokers USA United States of America

Too loose and the tobacco burns too hot, creating harsh smoke that irritates even without lung contact