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Introduction Global policies and educational campaigns have successfully reduced tobacco prevalence throughout the world.14 Recently, new oral nicotine products, such as pouches, gum, lozenges, toothpicks and loose leaf products, that are labelled or marketed as being tobacco-free nicotine (TFN) have emerged onto the market.5 6 These products are distinct from nicotine replacement therapy (NRT) medications, which are Food and Drug Administration (FDA)-approved for smoking cessations, and are also available in the form of gum and lozenge