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Australian and New Zealand Journal of Psychiatry

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Additional reporting by Jennifer Geddes.

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analysis Sole users of smokeless tobacco had a 70% higher risk of heart failure and a 66% increased risk of dying from coronary heart disease, demonstrating that these products are not safer alternatives Tobacco harms your cardiovascular system, as it damages the endothelium, increases oxidative stress, impairs oxygen delivery, and promotes clot formation, even in brief or secondhand exposures Other studies have confirmed that all tobacco products deliver carcinogens and cause gene-level disruptions tied to respiratory symptoms and increased mortality Quitting requires targeting both nicotine addiction and behavioral triggers