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The tobacco is heated in the bowl at the top of the hookah and the smoke is filtered through the water in the base of the hookah

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As with tobacco smoking, the instantaneous effects of hookah use include higher systolic and mean arterial blood pressure, as well as elevated heart rate (HR) [17, 23, 161,162,163,164,165,166]

As for nicotine, due to REACH, companies handling chemicals in the amount above 1 ton annually must register chemicals at the European Chemicals Agency (ECHA)

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