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Role of tobacco and microbes in oral carcinogenesis: Tobacco use, its forms, products and additives (cigarette, snuff, gutka , betel quid, areca nut), and derivatives (like tobacco-specific nitrosamines) have direct carcinogenic effects on the oral mucosa

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It is one of the reasons why there have been talks of a ZYN ban in the US

Then ask yourself, who authored the FDA announcement