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"It is a rapidly evolving market where consumer interest and trial has possibly run ahead of the ability of the technology to deliver consistent consumer satisfaction," said Cooper

Exposure to secondhand smoke, which increases the risk of lung cancer among nonsmokers, has also dropped substantially over the past three decades (58)

Spain, Iceland) are moving to treat pouches as tobacco products or impose strict limits (flavor bans, nicotine caps, label restrictions)

A review of evidence on filters causing cancer found filter ventilation has contributed to the rise in lethal adenocarcinomas, and recommended filter ventilation be banned