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Tobacco smoking was associated with increased LV and RV end-systolic volume (4.98 2.08 mL, 5.19 2.62 mL, P = 0.018, 0.049 respectively), reduced LV and RV ejection fraction (: 2.21 0.82%, 2.06 0.87%, P = 0.007, 0.019 respectively), and reduced absolute measures of LV peak global longitudinal, radial, and circumferential strain (: 0.86 0.30%, 2.52 0.99%, 1.05 0.32%, P = 0.004, 0.011, 0.001 respectively)

"Although nicotine itself is not a carcinogen, we do not know if people who start by using oral nicotine pouches will continue to find them satisfying, or if they will eventually start using more harmful products, like snuff or cigarettes," Keller-Hamilton says

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