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Because active smoking is strongly associated with increased disease risk, greater misclassification of an actively smoking spouse as a non-smoker among spouses of smokers compared with spouses of nonsmokers would lead to risk estimates for spousal smoking that are biased upward by the effect of active smoking

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As of 2019, however, group 4 in IARCs classification stands empty: caprolactam was upgraded to group 3, carcinogenicity not classifiable, after a review of evidence