J S-R, SDD, AOD, and DC contributed to reviewing the manuscript
PedsQL 4.0: reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations
Signs your strength is too high Dizziness or light-headedness within 5 minutes of placing a pouch Nausea or stomach discomfort , especially on an empty stomach Headache that starts 1015 minutes into use Rapid heartbeat or feeling jittery and anxious An overwhelming gum tingle that is genuinely uncomfortable rather than pleasant Signs your strength is too low No noticeable nicotine effect even after 1520 minutes Persistent cravings immediately after removing the pouch Needing to use two or more pouches in a row to feel satisfied Returning to cigarettes or other nicotine products within the same session If you experience too-high symptoms, remove the pouch immediately and rinse your mouth with water
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The prevalence was lowest for age groups 1824 and 5059 years
