In a study at a university in the USA, 48.4% of students reported having ever used a waterpipe, and 20% used a waterpipe for tobacco smoking in the past 30 days.7 It has been suggested this is due to the sweet flavours of maassel (tobacco soaked in flavoured sugar syrup) which makes it a more pleasant alternative to cigarettes among the younger generation.8 When asked why they use waterpipes, common answers include filling up free time and socialising with friends.9 ,10 Many smokers have the misconception that using a waterpipe is less harmful than other ways of using tobacco.1113 They believe it is safer than smoking cigarettes due to the smoke's passage through water which is thought to filter out much of the toxicants.9 ,12 ,14 However, a recent systematic review found that waterpipe tobacco smoking was significantly associated with various diseases.15 Toxicants such as polycyclic aromatic hydrocarbons (PAHs), nicotine, tar and particulate matter remain in the inhaled smoke and can pose serious harm to health.1618 Smoking a waterpipe has also been linked to lung cancer, respiratory illnesses, periodontal diseases and low birth weight.15 ,1924 Studies have also indicated a possible association between waterpipe usage and infectious diseases, such as tuberculosis, due to the sharing of the mouthpiece during sessions.25 ,26 Compared with cigarettes, waterpipe use exposes the smokers and passive smokers to lesser quantities of toxicants in one puff
### Tobacco Stops With Me is a statewide campaign, funded through the Oklahoma Tobacco Settlement Trust, that provides an efficient, emotional and highly recognizable tobacco-free message for Oklahomans to rally around
Many things can lead to it, including: Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or naproxen Overuse of alcohol, tobacco, or cocaine Repeated vomiting Stress, such as that caused by an injury, surgery, or serious illness Infections caused by bacteria such as H
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