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Tobacco products come in a variety of forms that are used in different ways. In addition to leaf tobacco products, they are available as skin patches, chewing gum, nasal and oral sprays, inhalers, lozenges and tablets, and electronic nicotine delivery systems (ENDS).  

ENDS products use an “e-liquid” that usually contains nicotine derived from tobacco, as well as flavorings, propylene glycol, vegetable glycerin, and other ingredients. The liquid is heated to create an aerosol that the user inhales.

Self-reporting of nicotine exposure often may be biased and lead to inaccurate measures of exposure. Hence, biomarkers are often used to provide objective measures of nicotine exposure. Studies on tobacco products typically collect the quantities of the tobacco product used through self-reporting, while the actual nicotine exposure is measured by biomarkers. 

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