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J Clin Invest 2001

These observations indicate a deterministic shift of healthy oral microbiome during environmental stress conditions, like tobacco consumption, to a more dispersed microbial community composition in tobacco consuming individuals that is similar to the microbiome associated with OSCC buccal site ( Figure 7 )

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These factors include inductive tobacco advertisement and promotion, higher life stress accompanied by a fast life pace, and affordable and easily accessible cigarettes