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Two of these prospective within-subject studies assessed changes in oral mucosa amongst current users, consistently reporting a reduction in pre-existing snus-associated lesions or an improvement in lesion severity over short follow-up periods ( Given the limited number of available studies, the lack of a control group in almost all current studies, the absence of long-term prospective data, and the relatively recent introduction of these products, the long-term implications of nicotine pouches in oral carcinogenesis remain unclear

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But tobacco companies claim that the new measures benefit the black market and that illegal tobacco sales have tripled in Australia in the past year