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Chewing Tobacco as a Risk Factor for Diabetes Research suggests that smokeless tobacco use is not just harmful but could also be a risk factor for type 2 diabetes
doi: 10.1097/00005537-199606000-00014

They should be used with caution by persons with or at risk of an unstable heart condition or high blood pressure

[DOI] [PubMed] [Google Scholar] 40.McKlveen JM, et al