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While this shift may seem small, it represents an additional 350,000 Americans quitting smoking in 2014-15.

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However, what the American Lung Association is not informing the public is that the levels of nitrosamines detected in nicotine pouches were extremely low -- essentially trace levels -- and that these levels are two orders of magnitude lower than the nitrosamine levels in some brands of nicotine gum, which the American Lung Association heavily endorses. METACOMMENTARY: Why Metas move to community notes is good

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Does smoking affect pregnancy outcomes