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Participants: 14,344 adults Baseline Age: Mean 54.1 years Demographics: 54.8% female, 26.4% Black Follow-Up: Median 27.6 years (maximum 32.1 years) PAD Events: 635 incident cases Key Findings Incidence Rate: Smokeless tobacco users: 4.44 per 1,000 person-years Non-users: 1.74 per 1,000 person-years Hazard Ratio (HR): Current vs

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For CBD cigarettes, a person will use them in a similar manager to tobacco cigarettes, by burning one end and inhaling smoke from the other end