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Models of toxicity of diacetyl and alternative diones

Furthermore, carcinogenic tobacco specific nitrosamines (TSNAs), such as N-Nitrosonornicotine and 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone, have been detected in many nicotine pouch products, albeit generally at much lower levels than in traditional smokeless tobacco or cigarettes (13, 18)

The tobacco may already be slightly disturbed, making it harder to achieve an even pack