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Although the cardiovascular health effects and the underlying mechanisms by the water pipe tobacco smoking increases CVD risk have not been studied to the same extent as those of cigarettes, they are likely similar," the researchers wrote

Adam Goldstein, director of Tobacco Intervention Programs at the University of North Carolina School of Medicine

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[4] If youre using an apple, place the hole on the side of the stem or snip the stem with some scissors before puncturing the fruit