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In a small 2022 study, researchers found there was a slight drop in testosterone levels among baseball players 30 minutes after chewing nicotine gum

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Reference Source Toxicological evaluation of novel heat-not-burn tobacco products non-technical summary

Smokeless tobacco use also serves as a gateway drug for cigarette smoking among young adult males, with both past and current users approximately 225 percent more likely to have initiated smoking than non-users