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It increases the risk of heart disease, which can lead to stroke or heart attack

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The Global Burden of Disease : 2004 Update (PDF)

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Those smoking 11 to 15 CPD faced even greater dangers, with an 87 % higher risk of CVD and a 130 % higher risk of death from any cause compared to people who had never smoked

Common alternatives include nicotine pouches, vapes, other nicotine replacement therapies (patches, gums, lozenges), and heated tobacco products