introduced by Grizzly in select markets. It consists of wider strands than long cut. Grizzly Wide Cut Wintergreen is the only wide cut available. Flavoring Dipping tobacco is typically flavored. The most common flavors consist of mint, wintergreen, straight, and natural. Health issues Effects Dipping tobacco, like other tobacco products, contains the stimulant nicotine. Effects include increased heart rate, an increase in systolic blood pressure, and an increase in adrenaline. Long-term effects Long term use results in whitening of the oral mucosa, termed smokeless tobacco keratosis. There is relatively low risk of transformation of this lesion into mouth cancer (sometimes verrucous carcinoma). Dipping tobacco causes fatal oral cancers, tooth and gum loss. Associated cancers include: tongue cancer, lip cancer, cheek cancer, gum cancer, throat cancer, and cancer in the roof and floor of the mouth. A 2002 epidemiological literature review noted "The use of moist snuff and chewing tobacco imposes minimal risks for cancers of the oral cavity and other upper respiratory sites, with relative risks ranging from 0.6 to 1.7." A study comparing oral cancer mortality rates of West Virginia (the state with the highest consumption of smokeless tobacco) in the early nineties to the US overall average throughout the years 1950 to 1980 found no apparent increased incidence or mortality. A study, pooling results from 11 studies between 1981 and 2006, found that users of smokeless tobacco are at elevated risk of getting head and neck cancer, particularly oral cavity cancer. Cardiovascular effects Studies are inconclusive as to how significantly smokeless tobacco affects users' cardiovascular systems, but it has been suggested that it may have less nicotine than cigarettes. One study states that, "Although the evidence is not conclusive, the adverse cardiovascular effects of smokeless tobacco use are less than those caused by smoking but are more than those found in non-users." Other studies also indicate that smokeless tobacco related cardiovascular risks are lower than that of smoked tobacco. One study states that smokeless tobacco use has a "positive effect on cardiovascular risk factors in young physically fit men." However, one Indian study from the state of Rajasthan states, "There is a significantly greater prevalence of multiple cardiovascular risk factors obesity, resting tachycardia, hypertension, high total and LDL cholesterol, and low HDL cholesterol, and electrocardiographic changes in tobacco users, chewing or smoking, as compared-to tobacco non-users. Chewing tobacco is associated with similar cardiovascular risk as smoking." Due to