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A recent network meta-analysis assessing oral health effects across non-combustible nicotine products did not identify any eligible randomized controlled trials on nicotine pouches, and the relatively short follow up period of the included studies did not allow for evaluation of their potential impact on oral carcinogenesis (60, 61)

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While most groups experienced a rise in co-use of cannabis and tobacco, young adults aged 18-25 bucked the trend, with co-use declining after 2014