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A typical cigarette requires about twenty puffs, while the average hookah user sits for about an hour and takes over 100 puffs, says Folkenroth

Alterations in oral microbial flora induced by waterpipe tobacco smoking

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The harmful toxins that enter your body through cigarettes include carbon monoxide, tar, formaldehyde, hydrogen cyanide, ammonia, mercury, lead, and cadmium and these all restrict blood flow to the skin and even break down elasticity structures in the skin, like collagen and elastin