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These conflicting findings may be explained by differences in participant selection and environmental context across studies

As a result, mouth pieces and water bowls of hookahs become easily contaminated and become modes of transmission for a variety of bacterial and viral illnesses and diseases

Aneurysms are hard to catch before they rupture and a ruptured aneurysm is life-threatening

Spending on tobacco products, absenteeism from work and school, and loss of income due to smoking-related disease and premature death of breadwinners substantially reduce the capacity of a household to accumulate assets such as a family home, to insure against losses, to save for retirement, and to pass on assets to the next generation ( Figure 9.5.1 )