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In contrast, Model 3 addresses the contribution of regular khat chewing

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Eur J Cancer

An ulcer that lasts longer than 3 weeks may indicate an underlying health problem requiring medical intervention or could represent a more serious condition, including oral cancer

5 The panel unanimously agreed and wrote that cigarette smoking caused lung cancer and chronic bronchitis and was strongly associated with cancer of the mouth and larynx

The researchers noted that concentrations of these elements "were higher than or equal to the corresponding concentrations in conventional cigarette smoke", and that "many of the elements identified in [e-cigarette] aerosol are known to cause respiratory distress and disease"