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A machine-learning classifier based on metagenomic signatures effectively identified EC users, including those who use ECs alone or alongside cigarettes, raising concerns about the safety of ECs and challenging harm reduction claims [62]

The structural and chemical differences among the three groups affect the cellular uptake pathways of the CPPs, which are either energy-independent or energy-dependent 4,5

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Additionally, smoking has been found to increase the production of certain enzymes that convert testosterone into estrogen, leading to an imbalance in the sex hormones