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Shared decision-making should be used to help guide patients to interventions, including potential combinations of interventions, that are effective, most closely fit their values and preferences, and are accessible (Table 1)

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Nevertheless, a significant number of biomarker-based studies, cell/ in vitro and animal studies did indicate that e-cigarette exposure can result in oxidative stress, cellular apoptosis, DNA damage, genotoxicity, and tumor growth (Figure 2, and Supplementary file Materials 2 and 3), all of which can potentially increase risk of developing lung cancer or progression of any cancer