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Heterogeneity of biological models While human clinical studies are available, the vast majority of studies aiming at investigating potential toxic effects of e-cigarettes use preclinical models such as cell culture and animal models [7]

Finally, the relationship between smoking and health might not be entirely causal, as certain unobserved factors, such as personal characteristics, social settings, and genetic predispositions, might concurrently influence both smoking habits and poor mental and physical health 17

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