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It is enjoyed by pipe enthusiasts throughout the country, smoked pure or frequently mixed with other tobaccos to produce the desired recipe

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This is rather a public health priority given hookahs prevalence (12.4%) [58], coupled with the relatively high passive exposure to hookah smoke (32.8%) during gestation [59], which in turn leads to the involuntary exposure of innocent fetuses to hookah, and subjecting them to hookahs potential harmful effects [60]

Additionally, information on overall US sales of shisha tobacco, charcoal, and waterpipe services along with geographical sales data and trends remains scant