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Temperance groups began to concentrate their efforts on alcohol

Search terms included Smokeless tobacco OR smokeless tobacco product OR chewing tobaccoOR reduced risk tobaccoOR non-cigarette tobacco OR snus OR snuff AND health outcome OR morbidity OR mortality OR cancerOR cardiovascular diseaseOR chronic obstruct pulmonary disease OR COPD OR CVD OR acute myocardial infarctionOR stroke OR cardiovascular OR cerebrovascularOR health effectsOR adverse OR effects OR respiratory

[4] Due in no small part to successful campaigning against tobacco use, sales of pipe tobacco in Canada fell nearly 80% in a recent fifteen-year period to 27,319 kilograms in 2016, from 135,010 kilograms in 2001, according to federal data

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BEFORE going downhill, slow down and shift the transmission into a lower gear