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Further research is needed to determine whether or not chewing tobacco use presents a significant risk of heart disease and stroke

The exposure of smokeless tobacco users and smokers to carcinogens and toxicants can now be monitored by urinary and DNA adduct biomarkers that may be able to identify those individuals at highest risk of cancer so that effective cancer prevention interventions can be initiated

According to legends, Vietnam betel nut chewing and areca nuts custom has been a custom since the Hung King period and are connected with the antique legend of betel and areca

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