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Betel nut fruit in various stages of ripeness Tightly wound tobacco leaves Betel leaves, coiled into cones, ready for their mixture of natural nicotine A birds eye view of the average customer, in their 60s-80s

If plaque breaks open, a blood clot can form and block blood flow, which may lead to a heart attack or stroke

Notably, more recent products utilize nicotine in things like electronic cigarettes and nicotine oral pouches and lozenges

doi:10.1001/jamainternmed.2019.3487 23

Some industry observers question whether Blue Whales product falls under the jurisdiction of the Food and Drug Administration, as a food product that contains nicotine

"'Ketamine Queen' Jasveen Sangha pleads guilty to supplying fatal dose that killed Friends star Matthew Perry"