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Tobacco-Free and Spit-Free Convenience

This is especially troublesome as adolescents continue to be exposed to harmful tobacco product constituents, in particular nicotine that might interfere with brain development, cause addiction, and might lead to sustained future tobacco use [53]

While they lack tobacco leaf content, they still pose risks to oral health, including gum irritation and potential dependence. Chemical Composition and Oral Health Implications Smokeless tobacco products contain a complex mixture of chemicals, including: Nicotine : An addictive substance that constricts blood vessels, reducing blood flow to the gums and impairing healing. Tobacco-specific nitrosamines (TSNAs) : Potent carcinogens linked to oral and other cancers. Sugars and flavorings : Added to enhance taste but contribute to tooth decay

A ranking of 1 represents strong and repeated findings, 2 represents consistent findings

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