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Evidence also exists that vaping among youth is associated with increased likelihood of later cigarette smoking and other substance use

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E., Hyland, A., Li, Q., Steger, C

Impaired efferocytosis by alveolar macrophages appears to be an important contributor to the exacerbated cellular inflammation not only in COPD, but also in asthma, bronchiolitis obliterans, protracted bacterial bronchitis and bronchiectasis in children [216,218,219,220,221]

Another hypothesis is that CSSD may be associated with viral infections such as the Epstein-Barr virus, cytomegalovirus, and human herpesviruses (HHV6 and HHV8)