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Further, our current findings corroborate conclusions drawn from previous studies done by us and others in the field [19, 21, 22, 32, 33] that indicate that IQOS is as detrimental to pulmonary health as are combustible cigarettes
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Collectively, these studies demonstrate that smokeless tobacco induces oral microbiome dysbiosis characterized by enrichment of pro-inflammatory taxa (e.g., Fusobacterium and Prevotella ), depletion of symbiotic species (e.g., Lactobacillus and Neisseria ), and activation of carcinogenesis-linked metabolic pathways (nitrogen metabolism and LPS biosynthesis), with dose-dependent effects and product-specific virulence
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