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Additionally, dipping tobacco typically has more nicotine than regular chewing tobacco

The majority of the covariates are individual- and area-level confounders, although some covariates (such as year and region) were included to account for temporal and, to some extent, spatial variation in outcomes

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For example, from 2000 to 2010, China experienced accelerated urbanization, leading to increased exposure to risk factors such as tobacco and environmental pollutants 46,47

Dip sits against the gums and causes localized staining, while chew moves around the mouth, causing broader discoloration