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According to Castillo, its still unclear whether arecoline and arecaidinewhich the researchers used to identify betel nut consumptionare only found in betel nuts

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1-Antitrypsin suppresses TNF- and MMP-12 production by cigarette smoke-stimulated macrophages

[2] Using chewing tobacco can cause various harmful effects such as dental disease, oral cancer, oesophagus cancer, and pancreas cancer, coronary heart disease, as well as negative reproductive effects including stillbirth, premature birth and low birth weight