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Our findings have major clinical relevance as they suggest that, like tobacco smoking, e-cigarette use during chemotherapy might increase cisplatin resistance, reducing therapy efficacy, and worsening patient prognosis

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It is fundamental to individualize what to do next according to the symptoms and distress experienced by the patient: Increase the intensity and frequency of cessation counseling or refer the patient to a tobacco dependence specialist for a more intensive treatment if the patient is willing [2]