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In many of the countries with the highest usage, the use of chewing tobacco and other smokeless tobacco products is associated with important cultural practices or social norms 6,7

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Although we are selling this as "solid leaf" grade, some of these leaves could qualify as wrapper or binder grade leaves

Also, because this was a cross-sectional survey, we are unable to draw conclusions regarding the causation between packaging elements and perceptions of appeal and harm

Officials from the public health groups worry that the ban may be punted well into next year, perhaps even after the November presidential election