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There may be no long-term damage if youve only been using smokeless tobacco products for a few weeks or months

The ritual and hand-to-mouth action create a psychological dependence thats hard to break

Treatment plans may involve individual or group therapy and the use of behavioral therapy, such as cognitive-behavioral therapy, to address the relationship between thoughts, feelings, and actions

They are appropriate for initial or followup tobacco dependence treatments (new or established patient)

This uncertainty can leave health care providers with questions on how ENDS should be discussed with their adult patients