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In Bangladesh, a significant increase in AQSLT was observed in the 45 years age group, rising from 23.36% in Wave 1 to 28.41% in Wave 2 (RC=21.37%, p=0.002)

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37 , 38 It has been suggested that nicotine pouches may introduce the 'gateway effect', providing a steppingstone to cigarette smoking due to the combination of addictive nicotine, pleasant flavours and attractive packaging