Theres no wiggling in nuts or trying to buy and place cams and all of that
doi: 10.1038/s41586-023-06968-8 67 Tomas-OjerPPuthenparampilMCrucianiCDocampoMJMartinRSospedraM
It needs tremendous amounts of willpower

Key sources included the US Food & Drug Administration (FDA) Center for Tobacco Products, Federal Trade Commission (FTC) Smokeless Tobacco Reports, Centers for Disease Control and Prevention (CDC) Office on Smoking and Health, National Institutes of Health (NIH) National Cancer Institute, World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), European Commission Tobacco Products Directive (TPD), CDC National Youth Tobacco Survey, Global Adult Tobacco Survey (GATS), NIH Surveillance Epidemiology and End Results (SEER) Database, Tobacco Merchants Association (TMA) Statistical Reports, International Smokeless Tobacco Council (ISTC) Bulletins, Euromonitor International Tobacco Industry Database, Nielsen Retail Scanner Data (Convenience Track System), Eurobarometer Tobacco Special Surveys, national health ministry reports from India (Ministry of Health & Family Welfare), Bangladesh (Directorate General of Health Services), and Scandinavian public health agencies (Swedish Public Health Agency, Norwegian Institute of Public Health)
