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There is growing evidence that hookah tobacco (also known as waterpipe tobacco and narghile) affects heart rate and blood pressure and causes an increased risk of coronary artery disease (20)

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What the damage actually looks like Heres what an X-ray of a normal, healthy lung looks like (left) and one of a lung damaged by smoking (right)

Theres also the issue of freshness and quality control

Learn more about tar in cigarette smoke here.

Notice the word somewhat. Cigarettes, on the other hand, are generally inhaled, making them a more direct line to health issues