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Sources: - National Cancer Institute, Smokeless Tobacco and Cancer, 2022

To assess the robustness of our findings and minimize the impact of confounding variables, including smoking, snus or cannabis use, excessive alcohol consumption, recent antibiotic use, and chronic somatic diseases, the study design included a sensitivity analysis where these participants were excluded (Fig

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This combination enhances oxidative stress and cellular damage, especially in chronic smokers, potentially accelerating the development of cancerous growths in the lungs