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According to Abhinav Agrawal, MD, director of interventional pulmonology and bronchoscopy at Northwell Health, One of the issues with legalization is that it contributes to the false perception that risk is low, he says

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The Mayo Clinic recommends combining behavioral strategies with physical alternatives when managing tobacco cravings suggesting that the ritual replacement aspect of pouches (something to do with your mouth, something to hold) is a genuinely useful component of the switch, not just a nicotine delivery mechanism [9]

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