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Tobacco smoke contains carcinogens that directly damage DNA in lung cells Accumulated DNA damage causes abnormal cells to grow uncontrollably Risk increases with the duration and intensity of smoking, even light smoking contributes 3

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Multinomial linear regression A series of linear models (estimated using ordinary least squares (OLS) regression) were fitted in R to predict each outcome variable of interest, using HEIC-PA, HEIC-FE, as well as all other outcome variables plus age at assessment, sex, and area-level socioeconomic deprivation as predictor variables