doi: 10.1161/01.cir.94.1.6
Paan (betel leaves) being served with silver foil at Sarnath near Varanasi, India South Indian style Paan Chocolate paan in a store in Bangalore (2026) Paan dan from Punjab, India, 19th century, Walters Art Museum, Baltimore
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Also, tobacco is associated with many oral pathologies including oral and pharyngeal cancers, periodontitis, tooth decay, mouth sores or leukoplakia
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The problem is that nicotine, a drug found naturally in tobacco, is addictive in fact, the CDC says that nicotine addiction has similar pharmacologic and behavioral characteristics to cocaine and heroin addictions