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Collectively, these studies demonstrate that smokeless tobacco induces oral microbiome dysbiosis characterized by enrichment of pro-inflammatory taxa (e.g., Fusobacterium and Prevotella ), depletion of symbiotic species (e.g., Lactobacillus and Neisseria ), and activation of carcinogenesis-linked metabolic pathways (nitrogen metabolism and LPS biosynthesis), with dose-dependent effects and product-specific virulence

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If you want a research-based summary comparing outcomes across nicotine replacement therapy, bupropion SR, and varenicline (including combination approaches), review the USPSTF tobacco cessation recommendation