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Footnote xxiv A 2014 review of 75 original articles, conducted on behalf of the Irish Department of Health, concluded that the "evidence unequivocally demonstrates that plain packaging is perceived as less attractive and less appealing, particularly among youth and young adults." The effects of plain and standardized packaging were observed in both non-smokers and smokers, including on measures of attractiveness, preference and intentions to smoke

However, smokeless tobacco contains nicotine and cancer-causing chemicals and may increase the risk of death from heart disease and stroke