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In countries where this industry is highly regulated, however, the conditions for market entry are so restrictive, particularly due to the very strong loyalty of customers to established brands, that they prevent the emergence of new entrants.[13]The reduction in the possibilities of competition through acquisition has thus contributed to directing the offensive attitude of the tobacco majors towards other sectors of activity

And cotinine concentrations in urine are 4 to 6 times higher than cotinine levels in blood or saliva

Some criticisms have also focused on the fact that it is not possible to establish relative risks