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Major Harmful Substances Removed: Approximately 90% of tested toxicants including tobacco-specific nitrosamines (TSNAs), volatile organics, and carcinogens are either at trace levels or undetectable in nicotine pouches compared with cigarette smoke (UK Gov Review, 2022, BMJ, 2024)

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A key strength of this study was that data was collected through face to face interview by an Android pad assisted electronic questionnaires, the automated logical check schedule in data collection process and the whole course audio record ensured a high data quality