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In reality, a relatively small proportion of counties (though representing a disproportionately large share of the population) experienced statistically significant declines over this period

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That distinction means pouch users are less likely to get addicted to the product than are people who smoke cigarettes or vape much as people who chew coca leaves are less likely to get addicted than people who smoke crack cocaine, says Jonathan Foulds, a smoking cessation researcher at Pennsylvania State Universitys Cancer Institute