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With respect to carcinogenicity of hookah, it was reported that carcinoembryonic antigen (CEA) levels were higher in hookah smokers, in comparison to non-smokers, yet not as high as in cigarette smokers [133]

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Discussion Since the COVID-19 pandemic, the prevalence of substance use, including tobacco products, marijuana, opioids, and alcohol, has been increasing, especially among men of reproductive age 28,29

It accentuates any effect of alcohol on the liver, more attacks of chronic pancreatitis (irreversible damage of the pancreas leading to digestion insufficiency and diabetes), and more Crohns disease (a type of inflammatory bowel disease) 5) The damages caused by tobacco are cumulative that is accumulates over the years and depend on quantity, type, and duration of tobacco use