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Notably, tobacco carcinogen exposure led to significant changes in the gut and lung microbiomes, particularly in species like Odoribacter , Alistipes , Akkermansia , and Ruminococcus , which correlated with LUAD development and immunotherapeutic response

Similar results were seen with centrilobular and paraseptal emphysema, suggesting that the combination of cigarette and marijuana smoking may have a synergistic role on the lungs and airways

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