British medical bulletin
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The tobacco industry's strong-arm tactics have been used consistently over many years. These tactics include: using the industry's size, wealth, and legal resources to intimidate individuals and local governmental bodies; setting up 'front groups' to make it appear that it has more allies than it really does; spending large sums of money to frame the public debate about smoking regulations around 'rights and liberty' rather than health and portraying its tobacco company adversaries as extremists; 'investing' thousands of dollars in campaign contributions to politicians; and using financial resources to influence science. These tactics are designed to produce delay, giving the nicotine cartel more time to collect even more profits at the direct expense of millions of lives around the world.
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Smokeless tobacco practices are common in some parts of the world and the use seems to be increasing. Nicotine exposure is similar in smokeless tobacco users and smokers, often leading to strong physical dependence. As a rule, smokeless tobacco products contain high levels of nitrosamines with carcinogenic potency in experimental animals. ⋯ A recent study suggests that smokeless tobacco use is related to cardiovascular disease, which could be of great public health importance. The known and suspected health risks associated with the use of smokeless tobacco provide a basis for preventive action. In particular, efforts are needed to limit the introduction of such practices among young people, which may serve as a gateway to smoking.