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One hour of hookah smoking, the CDC reported, delivers three- to six-fold higher levels of carbon monoxide and 46-fold higher levels of tar than from a single cigarette. The WHO concluded, Even after it has been passed through water, the smoke produced by a waterpipe contains high levels of toxic compounds, including carbon monoxide, heavy metals and cancer-causing chemicals. Other studies have shown that, in addition to increasing ones carbon monoxide levels, hookah smoking caused peoples heart rates and blood pressure to rise significantly

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For all these cases, oral nicotine is a nice alternative way to ingest nicotine