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However as at 2020/21 9.5% of women were smoking at the time of delivery which was the lowest on record

The consequences of this repeated and prolonged episodes of reflux can damage the inner lining of the esophagus and increases the risk of esophageal cancer Tobacco and Peptic Ulcer Smoking stimulates acid secretion from stomach and attenuates the defense mechanisms like decrease in blood flow, mucus and bicarbonate production

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With scientific consensus still forming and regulation limited, the industry had considerable freedom in how it presented its products

Using language that signals a tobacco product is free of a substance may meet one criteria of an unauthorized modified risk claim under FDA rules

Zhao et al., 2023)