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Funding This work was supported by National Institutes of Health grants HLBI P01HL126609, P01HL060678, R01HL127342 (to V.N.)

Our literature search targeted primary studies published before June 2023

Participating in a support group can provide a sense of community and accountability, making it easier to stay committed to the goal of quitting

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While direct long term data are lacking, the known adverse cardiovascular pharmacology of nicotine, combined with the high exposure potential from pouches and the unique vulnerability of the developing adolescent cardiovascular and nervous systems, creates a strong basis for concern