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Compared to those without MHC, participants with MHC indicated that using ENDS helped them feel more relaxed and that stress management was a more important reason for ENDS use. Conclusions U.S. adults with MHC (and particularly never smokers with SPD) report disproportionately high use of ENDS. Individuals with MHC may be particularly likely to use ENDS for relaxation and stress management.Macrophages release a variety of extracellular vesicles (EVs). Here we describe a previously unreported class of EVs that are released from macropha