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Meanwhile, there was an increase in the mean score for difficulty to draw and harshness, even though these changes were not statistically significant in all the groups

Furthermore, hookah significantly decreases pulmonary function parameters, including FEV1, FEV1/FVC ratio, and FEF, as well as the levels of FeNO [110,111,112]

The number is hard to assess correctly because weve been seeing a slight decline of tobacco use in the western countries (so called 1st world countries) but no reliable data can be obtained for the rest of the world namely, 3rd world and developing countries

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