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Tobacco or Health, A Global Status Report(1) World Health OrganizationGeneva, WHO, 1997.

(2) Centers for Disease Control and Prevention, Office on Smoking and Health,

Smokeless Tobacco Fact SheetS, 2002.

(3) Blot WJ, McLaughlin JK, Winn DM, Austin DF, Greenberg RS, Preston-Martin S, et al. Smoking and drinking in relation to oral and pharyngeal cancer

Cancer Research, 1988, 48: 3282-3287.

(4) IARC Working Group on the Evaluation of the Carcinogenic Risk ofChemicals to Humans, International Agency for Research on Cancer, WorldHealth Organization. Tobacco habits other than smoking, betel-quid and areca-nut chewing, and some related nitrosamines. Lyon, International Agency for

Research on Cancer, 1985.

(5) Zahm SH, Blair A, Holmes FF, Boysen CD, Robel RJ, Fraumeni JF Jr. Acase-control study of soft-tissue sarcoma. American Journal of Epidemiology,

1989, 130: 665-674.

(6) Idris AM, Ahmed HM, Malik MO. Toombak dipping and cancer of the oral

cavity in the Sudan: a case-control study. International Journal of Cancer, 1995,

63(4): 477-480.

(7) Salem G, Juhl R, Schiodt T. Oral malignant and premalignant changes in

'Shammah'-users from the Gizan region, Saudi Arabia. Acta Odontologica

Scandinavica, 1984, 42:

41-45.

(8) Zhang X, Schmitz W, Gelderblom HR, Reichart PA. Shamrnah-induced oral

leukoplakia-like lesions. Oral Oncology, 2001, 37: 609-612.

(9) Zaridze DG, Blettner M, Trapeznikov NN, Kuvshinov JP, Matiakin EG,Poljakov BP, et al. Survey of a population with a high incidence of oral andoesophageal cancer. International Journal of Cancer, 1985,36(2): 153-158.

(10) Winn DM. Epidemiology of cancer and other systemic effects associatedwith the use of smokeless tobacco. Advances in Dental Research, 1997, 11: 313-

321.

7

(11) Bouquot JE, Meckstroth RL. Oral cancer in a tobacco-chewing USpopulation--no apparent increased incidence or mortality .Oral Surgery , OralMedicine, Oral Pathology, Oral Radiology and Endodontics, 1998,86: 697-706.

(12) Mashberg A, Boffetta P, Winkelman R, Garfinkel L. Tobacco smoking

alcohol drinking, and cancer of the oral cavity and oropharynx among U .S.

veterans. Cancer, 1993,72: 1369-1375.

(13) Sterling TD, Rosenbaum WL, Weinkam JJ. Analysis of the relationship

between smokeless tobacco and cancer based on data from the National Mortality

Followback Survey. Journal of Clinical Epidemiology , 1992, 45: 223-231.

(14) Lewin F, Norell SE, Johansson H, Gustavsson P, Wennerberg J, BiorklundA, et al. Smoking tobacco, oral snuff, and alcohol in the etiology of squamouscell carcinoma of the head and neck: a population-based case-referent study inSweden. Cancer, 1998, 82: 1367-75.

(15) Schildt EB, Eriksson M, Hardell L, Magnuson A. Oral infections and dentalfactors in relation to oral cancer: a Swedish case--control study. European

Journal of Cancer Prevention, 1998, 7: 201-206.

(16) Gupta PC, Bhonsle RE, Mehta FS, Pindborg JJ. Mortality experience inrelation to tobacco chewing and smoking habits from a 10-year follow-up study inErnakulam District, Kerala. International Journal of Epidemiology, 1984, 13:184-187.

(17) Gupta PC, Mehta HC. Cohort study of all-cause mortality among tobaccousers in Mumbai, India. Bulletin of the World Health Organization, 2000, 78:877-883.

(18) Accortt NA, Waterbor JW , Beal1 C, Howard G. Chronic disease mortality in

a cohort of smokeless tobacco users. American Journal of Epidemiology, 2002,

156: 730-737.

(19) Bolinder G, Alfredsson L, Englund A, de Faire U. Smokeless tobacco useand increased cardiovascular mortality among Swedish construction workers.

American Journal of Public Health, 1994, 84(3): 399-404.

(20) Bolinder OM, Ahlborg BO, Lindell JH. Use of smokeless tobacco: bloodpressure elevation and other health hazards found in a large-scale populationsurvey. Journal of Internal Medicine, 1992, 232(4): 327-334.

(21) Eliasson M, Asplund K, Evrin PE, Lundblad D. Relationship of cigarettesmoking and snuff dipping to plasma fibrinogen, fibrinolytic variables and seruminsulin. The Northern Sweden MONICA Study, 1995, 113: 41-53.

8

(22) Huhtasaari F, Lundberg V, Eliasson M, Janlert U, Asplund K. Smokelesstobacco as a possible risk factor for myocardial infarction: a population-based

study in middle-aged men. Journal of the American College of Cardiology, 1999,34: 1784-1790.

(23) Persson PG, Carlsson S, Svanstrom L, Ostenson CG, Efendic S, Grill V,Cigarette smoking, oral moist snuff use and glucose intolerance. JournalofInternal Medicine, 2000, 248: 103-110.

(24) Agrawal P, Chansoriya M, Kaul KK. Effect of tobacco chewing by motherson placental morphology. Indian Pediatrics, 1983, 20: 561-565.

(25) Krishna K. Tobacco chewing in pregnancy. British Journal of Obstetrics and

Gynaecology, 1978, 85: 726-768.

(26) Krishnamurthy S, Joshi So Gender differences and low birth weight withmaternal smokeless tobacco use in pregnancyo Journal of Tropical Pediatrics,

1993, 39(4): 253-254.

(27) Verrna RC, Chansoriya M, Kaul KK. Effect of tobacco chewing by motherson fetal outcome. Indian Pediatrics, 1983, 20: 105-111.

(28) Mehta AC, Shukla S. Tobacco and pregnancy. Journal of Obstetrics andGynaecology of India, 1990, 40: 156-160.

(29) Tomar SL, Winn DM, Swango PA, Giovino GA, Kleinrnan DV. Oral

mucosal smokeless tobacco lesions among adolescents in the United States.Journal of Dental Research, 1997, 76: 1277-1286.

(30) Winn DM. Tobacco use and oral disease. Journal of Dental Education,2001, 65:306-312. ~

(31) Hoffmann D, Adams JD, Lisk D, Fisenne I, Brunnemann KD. Toxic andcarcinogenic agents in dry and moist snuff. Journal of the National Cancer

Institute, 1987,79(6):1281-1286.

(32) Hoffrnann D, MVD. Chemical composition and carcinogenicity of smokelesstobacco. Advances in Dental Research, 1997, 11: 322-329.

(33) ldris AM, Ibrahim SO, Vasstrand EN, Johannessen AC, Lillehaug JR,Magnusson B, et at. The Swedish snus and the Sudanese toombak: are theydifferent? OralOncology, 1998, 34: 558-566.

9

(34) Zaridze DG, Safaev RD, BelitSky GA, Brunnemann KD, Hoffmann D.Carcinogenic substances in Soviet tobacco products. IARC Scientific Publications,1991, 105: 485-488.

(35) Henningfield JE, Fant RV, Tomar SL. Smokeless tobacco: an addictingdrug. Advances in Dental Research, 1997, 11: 330-5.

(36) Hatsukami DK, Severson HH. Oral spit tobacco: addiction, prevention andtreatment. Nicotine and Tobacco Research, 1999, 1: 21-44.

(37) Tomar S. Snuff use and smoking in U .5. men. Implications for harmreduction (1). American Journal of Preventive Medicine, 2002, 23: 143.

(38) Henningfield JE, Rose CA, Giovino GA. Brave new world of tobaccodisease prevention: promoting dual product use? American Journal of PreventiveMedicine, 2002, 23: 226-228.

(39) Mackay J, Eriksen M. The Tobacco Atlas. Geneva, World Health

Organization,2002.

(40) U .S. Department of Health and Human Services. Preventing tobacco useamonR vounR oeoole. A reeort of the Sur{7eon General. Washington DC, U.S,Government Printing Office, 1994.

(41) Food and Drug Administration. 21 CFR Part 801, et al. Regulationsrestricting the sale and distribution of cigarettes and smokeless tobacco to protectchildren and adolescents; fmal rule. Federal Register, Q1 (168), 44396-45318,1996.

(42) Smokeless tobacco advertising expenditures before and after the smokelesstobacco master settlement agreement. A report of the Massachusetts Departmentof Public Health. Boston, May 2002.

(43) Gupta'PC, Ray SR. Tobacco and youth in the South East Asia Region.Indian Journal of Cancer, 2002, 39: 3-34.

(44) Connolly G. The marketing of nicotine addiction by one oral snuffmanufacturer. Tobacco Control, 1995, 4:73-79.

(45) Andersson G, Axell T, Larsson A. Impact of consumption factors on softtissue changes in Swedish moist snuff users: a histologic study. Journal of OralPathology and Medicine, 1990, 19: 453-458.

(46) The Global youth Tobacco Survey Collaborative Group. Tobacco use

among youth: a cross country comparison. Tobacco Control, 2002, 11: 252-270.

10

(47) Rodu B. An alternative approach to smoking control. The American Journalof the Medical Sciences, 1994,308: 32-34.

(48) Henningfield 1£, Fagerstrom KC. Swedish Match Company, Swedish snusand public health: a harm reduction experiment in progress? Tobacco Control,2001,10: 253-257.

(49) Haddock CK, Weg MY, DeBon M, Klesges RC, Talcott OW, Lando H, et al.Evidence that smokeless tobacco use is a gateway for smoking initiation in youngadult males. Preventive Medicine, 200 I, 32: 262-267.

(50) Tomar SL, Henningfield lE. Review of the evidence that pH is a determinantof nicotine dosage from oral use of smokeless tobacco. Tobacco Control, 1997, 6:219-225.(51) Brunnemann KD, Prokopczyk B, Djordjevic MY, Hoffmann D.Formation and analysis oftobacco-specific N-nitrosamines. Critical Reviews inToxicology, 1996,26: 121-137.

(52) MDPH -08/21/01 -Massachusetts Department of Public Health IssuesChallenge to US Snuff Makers and Warns Consumers of High Cancer Risk Tiedto Smokeless Tobacco. (http://\V\vw .state.ma.us/dph/media/200 1/pr0821 a.htm)

(53) Djordjevic MY, Fan J, Bush LP, Brunnemann KD, Hoffmann D.Effects ofstorage conditions on levels oftobacco-specific N-nitrosamines and N-nitrosamino acids in U.S. moist snuff. Journal of Agricultural and FoodChemistry, 1993, 41: 1790-1794.

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