drawing of a cigarette pack Product Sketch Tutorial: Malboro Iconic cigarette packaging Images -

An alternative hypothesis is depicted on the right, in which inhalation of chemicals common in e-cigarette aerosols (propylene glycol, glycerin, nicotine, or THC) alters the inflammatory state of the lungs, including changing alveolar macrophages to a proinflammatory phenotype with the release of inflammatory cytokines (indicated by yellow circles), such that a second hit causes a pathologic inflammatory response

Very subtle scuff marks to the end of mouth piece from use and the interior appears to be clean inside free of smoking residue, so perhaps only used once or twice

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while rolling a cigarette yourself, you need to be very careful about the way you roll it