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Warnings and Precautions The cardiovascular effects of nicotine may be risky in patients with severe cardiovascular disease (peripheral occlusive arterial disease, cerebrovascular disease, unstable angina pectoris, and heart failure), vasospasms, uncontrolled hypertension, severe hepatic and/or renal insufficiency, and active duodenal and gastric ulcers

Despite that hookah tobacco usage shares the same safety concerns as cigarettes, a misconception exists that it is safer and less addictive 9,10

Tobacco Smoking, Alcohol Drinking and Risk of Oral Cavity Cancer by Subsite: Results of a French Population-Based Case-Control Study, the ICARE Study

Given that tobacco farming is labor-intensive and harvesting is done by hand, farmers are exposed to numerous agrochemicals that put them at risk of disease

Murthy, M.D., M.B.A