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Your Lungs Are The First To Suffer Both the CDC and ALA have found that hookah smoking can impact lung health

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The study was conducted in Great Britain, where participants included 697 people who smoked at least 15 cigarettes a day or who had diminished lung capacity consistent with regular smoking

Using within study comparisons, smoking one cigarette per day had 46% (interquartile range 24-56%) of the excess relative risk for that when smoking 20 cigarettes per day, and the corresponding estimate for five cigarettes per day was 57% (36-64%)