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These disparities stem from decades of structural, social, and institutional injustices and not only place disadvantaged populations in unfavorable living environments (e.g., with higher exposure to environmental carcinogens) (see Social and Built Environments) but also contribute to behaviors that increase cancer risk (e.g., smoking, alcohol consumption, or unhealthy diet) (215)Alcaraz KI, Wiedt TL, Daniels EC, Yabroff KR, Guerra CE, Wender RC

However, adding e-liquid to cells is considered non-physiologic, such that studies needed in primary cells exposed in vivo or exposed to vaped aerosols ex vivo are needed to confirm these findings