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In 2018, 5.0% of adults in the United States reported ever using a menthol-flavored tobacco product other than cigarettes, including menthol-flavored e-cigarettes

On one hand, the reduced NNAL levels in e-cigarette users compared with smokers support the argument for relative harm reduction, particularly in smoking cessation contexts

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However, less commonly, keratinized mucosa may also be involved, such as the dorsum (top surface) of the tongue or the gingiva (gums)