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Ramstrm, the director of the Institute for Tobacco Studies in Stockholm, and published in the British Dental Journal , the 2016 update to the Global Burden of Disease Study (GBD) found that the risk ratios (RRs) for developing oral and esophageal cancer due to the use of chewing tobacco were "significantly higher" than those associated with nasal snuff use

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It has occasionally been used to treat Tourette syndrome, attention deficit hyperactivity disorder, and for severe pain management in some patients that is not relieved by standard pain medications