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Given that some nicotine pouches deliver nicotine levels comparable to or higher than traditional ST or cigarettes, these long term risks associated with chronic nicotine exposure are highly relevant to pouch users, especially those initiating use in adolescence (7, 9, 10, 12)

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The psychoactive compounds of cigarettes increase dopamine, which leads to higher mental activity and feeling of pleasure

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found that using very low nicotine cigarettes (VLNC) did not lead to greater compensatory smoking to make up for the lack of nicotine