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The combustion of charcoal used to heat hookah tobacco may pose additional health risks, since this combustion process produces dangerous substances such as carbon monoxide, metals, and other chemicals

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Those who persisted in smoking exhibited poorer performance on hearing tests compared to their non-smoking counterparts, underscoring the direct correlation between smoking and hearing loss

Around 2005, initiation rates during late adolescence were lowest in boys and girls in North Europe, with 20 smoking initiations per 1,000 teens each year, and the highest rates were in boys from South Europe, with 80 initiations per 1,000 teens each year

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