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Regional disparities were evident: The ASDALYR attributable to chewing tobacco was highest in South Asian countries, including Pakistan, Nepal, India, and Bangladesh, which collectively accounted for over 80% of global chewing tobacco-attributable DALYs

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So, that means we have nearly 5 years to complete PMTA applications, but applications will still be required and those applications may be in a very different form than what the assumptions have been thus far

Epperson AE, Henriksen L, Prochaska JJ