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Using a multi-criteria risk analysis approach with conservative criteria weighting, we find that ENDS are an effective option to quit conventional cigarette smoking, Sharan noted

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Thus, prolonged or heavy use of hookah may induce risk of tumor development, especially in oral cavity and esophagus, which further argues against the notion that hookah has no/less harm if not inhaled kept in mouth. Indeed, incidence of benign lesions of the vocal cords was linked to the presence of cysts in 4.8% of hookah users, which was similar to cigarette smokers [134]

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Nature Reviews Genetics