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What we don't know yet is how harmful these very high nicotine spikes may be over time. Researchers are also studying whether nicotine pouches may affect: The oral microbiome (the bacteria that naturally live in the mouth) Saliva composition Blood pressure regulation Digestive health Inflammation throughout the body Early research suggests some users experience gastrointestinal symptoms such as bloating or stomach discomfort, though more studies are needed to know why

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The FDA did not answer questions about any former FDA lawyers now representing clients suing or going before the agency

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