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[14] A 2023 narrative review of alternative tobacco products in Gulf Cooperation Council countries described midwakh as a locally popular product for which evidence on chemical composition and health effects remains limited compared with conventional cigarettes

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In contrast, the Middle East & Africa is experiencing rapid growth due to increasing urbanization, expanding youth demographics, and a relatively relaxed regulatory environment

This information can be found at the websites of individual state health departments to which CDC provides a directory and hyperlink [57]