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For more detail, view the Evidence Review of E-cigarettes and Heated Tobacco Products 2018, a report commissioned by Public Health England.

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The surgeon general in 1964, Luther Terry, described the report's effect as a "bombshell." At the time, and for decades afterward, the tobacco industry tried to "poke holes" in research documenting the harms of smoking, Frieden says

Chemicals in tobacco smoke lead to cancer primarily through the introduction of carcinogens into the body, which damage cellular DNA and disrupt normal cell functions