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Carcinogenesis 8:465469 Brunnemann KD, Qi J, Hoffmann D (2004) Levels of TSNA in oral moist snuff in the past 30 years and today (Abstract No

In addition, smokers were not more prone to negative treatment outcomes, although a trend was observed (adjusted odds ratio [OR] 1.24, 95% confidence interval [CI] 0.911.70), and were more likely to be lost to follow-up, but this was also not significant (adjusted hazard ratio [HR] 2.09, 95% CI 0.894.94)

As plaque advances, it hardens and becomes tartar