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Furthermore, carcinogenic tobacco specific nitrosamines (TSNAs), such as N-Nitrosonornicotine and 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone, have been detected in many nicotine pouch products, albeit generally at much lower levels than in traditional smokeless tobacco or cigarettes (13, 18)

OConnor, M.D., of Boston University, wrote in an editorial accompanying the study

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County-by-county sales numbers for Illinois are not available because tobacco is taxed at the distributor level by the Illinois Department of Revenue