By Kelly Evans-Hullinger, M.D.
From Babe Ruth to John Wayne, Americans have seen chewing tobacco in popular culture for over a century. Spitting chew has been a trademark of cowboys and professional athletes alike and chewing tobacco use continues at high rates in the United States. In 2018 a survey showed 2.4 percent of American adults used smokeless tobacco, with snuff or snus pouch u...
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