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Users who start rolling pipe tobacco into cigarettes and inhaling may find themselves more dependent, smoking more frequently, and struggling harder to quit than they would with traditional pipe smoking

doi: 10.1111/eos.12072 93 DussorGOLeongASGraciaNBKiloSPriceTJHargreavesKMet al

Some even use tobacco ash as toothpaste

The time-to-event (year) was defined as the duration from the beginning of the follow-up to the date of cancer diagnosis, censoring, or the end of follow-up, whichever occurred first

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Additionally, the researchers found hookah smoking to heighten arterial stiffness to a degree comparable with the damage caused by smoking one traditional cigarette