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Smokeless tobacco and heart disease : Of the 23 studies reporting on the risk of heart disease in SLT users (Table I), 11 were conducted in European Region (EUR)1314151617181920212223, three each in American Region (AMR)242526 and Eastern Mediterranean Region (EMR)272829 and five were reported from South-East Asia Region (SEAR)3031323334

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As I noted in that post, recommendations change as new information becomes available particularly in a pandemic where little is known at the onset