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Smoking remains the leading cause of preventable death in the United Kingdom, accounting for over 77,000 deaths an estimated 2.5 billion in health care costs each year in England alone

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Several studies also suggest that exposure to electronic nicotine delivery systems can cause cellular hyperplasia (growth of cells) and metaplasia (change in cells) in mucosal lining in rats

Among these studies, three 103,288,498 had an outcome prevalence of less than 10% (Supplementary Table 2)

Five Brothers Burley Five Brothers Pipe Tobacco (1.25 oz pouch) is a robust, no-frills Burley blend flavored by experienced pipe smokers seeking a straightforward, high-nicotine experience

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