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"Part of [the reason] is the long-standing patterns and history of the tobacco industry targeting vulnerable populations to get them addicted to tobacco for a lifetime," Makaroff said

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The convergence of acetaldehyde-producing fungi, oncoviral cofactors (HPV/EBV), and nitrosamine-enriched bacterial consortia establishes a polymicrobial carcinogenic milieu, necessitating functional metagenomic studies to disentangle microbial contributions to OSCC progression and targeted interventions to restore mucosal homeostasis