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Cigars that appear swollen, spongy, or emit a sour odor may also have been stored improperly

It is recognized as a drug by anti-drug activists

As people moved closer from smoking to quitting, they were more likely to support health warnings on packaging (53% for pre-contemplators versus 72% for contemplators and 71% for quitting/relapsed)

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It also increased catalase activity in the lung and resulted in changes in the level and mRNA of major matrix metalloproteinases (MMP-1, MMP-9, and MMP-12), confirming pulmonary damage associated with hookah use [117, 118]

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