indiana youth tobacco survey use continues to decline but nicotine pouches gain popularity • Capital Chronicle Indiana Youth tobacco use lowest

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Tobacco use is associated with cancers of the mouth, gums, throat, and especially of the lungs

recession of the gum line and changes in the colour and texture of mouth tissue Accumulation of tartar (calculus) and plaque Ulcers, upset stomach and increased bowel activity Increased sensitivity to hot and cold Delayed healing after dental work Increased heart rate Risks Oral, pharyngeal (throat) and stomach cancer Cancers of the lungs and/or other parts of the body Heart disease

Therefore, a tobacco harm reduction risk assessment that would evaluate the toxicity of individual toxicants from e-cigarette aerosols or heat-not-burn smoke, and not consider the interactions or synergy between these chemicals, may overestimate the reduced harm of a tobacco product