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While highly unlikely, extreme cases of passive or environmental exposuresuch as prolonged contact in enclosed spaces with heavy smokecan result in detectable cotinine levels, especially in children or individuals with slow metabolism

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However, these nicotine replacement products are FDA-regulated, whereas nicotine pouches are not

Data In a pre- and postnatal development study, pregnant rats received up to 15 mg/kg/day of oral varenicline succinate through gestation and lactation Mean serum concentrations of varenicline in the nursing pups were 522% of maternal serum concentrations