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In particular, cigarette smoking is a cause of oral dysbiosis, affecting microbial diversity and its functional potential 5,7

A recent systematic review reported a strong association between the use of tobacco-containing betel quid and oral cancer incidence, with an odds ratio of 7.74 (95% CI: 5.3811.13) (35)

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Additionally, many municipalities, local school boards and boards of health have enacted by-laws and policies to limit vaping in their jurisdictions