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Cotinine, the primary nicotine breakdown product, is commonly tested for in nicotine screening tests, along with other related substances, because it remains in the body longer than nicotine itself

An alternative perspective is that pre-existing structural alterations may render some individuals more susceptible to acute pharmacologic effects and, in turn, to addiction

It can also negatively affect the entire body, causing lung and stomach problems, increasing blood pressure and heart rate, and narrowing arteries, which can lead to a heart attack

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While the product mostly appeals to current or former chewing tobacco users, Stearns said some smokers and coffee drinkers have also started using it