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While the MTT data cannot be translated directly to in vivo human effects, they do raise concern about the potential for these chemicals to cause harm to users at the concentrations currently used in some refill fluids
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[13] The same review said that claims about HTPs acting as a gateway to cigarette smoking in Japan were unclear because available evidence indicated that HTPs were mainly used by current or former smokers, with minimal uptake among people who had never smoked
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