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In addition, a stronger dependence on the e-cigarette compared to the traditional cigarette identified in dual users indicates that e-cigarettes may be highly addictive

First, longitudinal studies are needed to evaluate temporal mucosal changes over a substantive period, the incidence of premalignant conditions and long-term carcinogenic outcomes

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Twin studies estimate that nicotine dependence, withdrawal symptoms, and smoking behaviors are between 31% and 60% heritable