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Notably, Bacillota emerged as the predominant phylum across all experimental groups, exhibiting a relative abundance that varied between 35.64 and 61.19%, a finding that is consistent with the existing literature [22]

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Overall, declining cigarette use, growing acceptance of reduced-risk alternatives, premiumization, and sustained capital investment position the Japan HTP market for continued expansion and maturity through 2032, reinforcing its role as one of the worlds most advanced heated tobacco markets

Sanders willingness to speak publicly about these challenges helps dismantle stigma and normalize the conversation around survivorship

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