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This direct exposure damages cells and increases the likelihood of mutations that can lead to cancer.The Nature Communications study highlighted that even moderate use of chewing tobacco over time can result in precancerous lesions and a faster progression to malignant tumors compared to cigarette smoking

PMID: 20883788

Plug is loose tobacco leaves that have been sweetened and pressed into a brick shape

Smoking and Cancer In the US, investigators have reported that smoking is the single biggest risk factor for non-AIDS defining cancers among people living with HIV

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J Am Dent Assoc., 139(7):896-905