Muʽassel
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Muassel ( ar, معسل, meaning "honeyed"), or maassel, is a syrupy
tobacco Tobacco is the common name of several plants in the genus '' Nicotiana'' of the family Solanaceae, and the general term for any product prepared from the cured leaves of these plants. More than 70 species of tobacco are known, but the ...
mix containing
molasses Molasses () is a viscous substance resulting from refining sugarcane or sugar beets into sugar. Molasses varies in the amount of sugar, method of extraction and age of the plant. Sugarcane molasses is primarily used to sweeten and flavour foods ...
, vegetable
glycerol Glycerol (), also called glycerine in British English and glycerin in American English, is a simple triol compound. It is a colorless, odorless, viscous liquid that is sweet-tasting and non-toxic. The glycerol backbone is found in lipids known ...
and various flavourings which is smoked in a
hookah A hookah (Hindustani language, Hindustani: (Nastaleeq), (Devanagari), IPA: ; also see #Names and etymology, other names), shisha, or waterpipe is a single- or multi-stemmed instrument for heating or vaporizing and then smoking either tobacco ...
, a type of waterpipe. It is also known as "shisha". ''Argilah'' or ''Argileh'' ( ar, أرجيلة, link=no, sometimes pronounced ''Argilee''), and ''shisha'' or ''sheesha'' (), is the common term for the hookah itself in the
Arab world The Arab world ( ar, اَلْعَالَمُ الْعَرَبِيُّ '), formally the Arab homeland ( '), also known as the Arab nation ( '), the Arabsphere, or the Arab states, refers to a vast group of countries, mainly located in Western A ...
.


History

Although hookah pipes have been used for several hundred years, muʽassel is a recent invention, going back to the early 1990s. Before this, raw tobacco was smoked in hookah pipes, which was not very easy to use. The tobacco needed to be mixed with water, squeezed, and molded prior to use. It was hard to keep lit and produced a strong harsh smell and taste with a potent nicotine delivery. At the end of the twentieth century, hookah was no longer a very popular way to smoke tobacco, and in the Middle East was popular mainly among older, Arab men who smoked it with friends in cafes. Young people became interested in hookah use beginning in the early 1990s when milder sweetened and flavored hookah tobacco, commonly called Muʽassel, first became available. It is made by fermenting tobacco with molasses, glycerine and fruit essence, producing a moist and pliable mixture. Its ease of use and pleasant aroma and taste made it popular with young people. It quickly became the most common type of hookah tobacco globally, and sales skyrocketed, fuelled by the ever increasing variety, growing internet availability and advertising.


Culture


Middle East


Arab world

In many places in the
Arab world The Arab world ( ar, اَلْعَالَمُ الْعَرَبِيُّ '), formally the Arab homeland ( '), also known as the Arab nation ( '), the Arabsphere, or the Arab states, refers to a vast group of countries, mainly located in Western A ...
, the smoking of shisha is a part of traditional culture, and is considered a social custom. Social smoking is typically done with the use of a hookah with a single hose which is passed around the group or double
hose A hose is a flexible hollow tube designed to carry fluids from one location to another. Hoses are also sometimes called ''pipes'' (the word ''pipe'' usually refers to a rigid tube, whereas a hose is usually a flexible one), or more generally '' ...
, but some hookahs can employ up to four hoses. When the smoker is finished, the hose is either placed back on the table, signifying that it is available, or is handed directly to the next user. Social convention dictates that the mouthpiece and hose should be folded back on itself in such a way that the
mouthpiece Mouthpiece may refer to: * The part of an object which comes near or in contact with one's mouth or nose during use ** Mouthpiece (smoking pipe) or cigarette holder ** Mouthpiece (telephone handset) ** Mouthpiece (woodwind), a component of a woodw ...
is not pointing at the recipient. Disposable mouth tips are sometimes used in cafes. Many cafés in the Middle East offer hookah. Cafés are widespread and are common social gathering places (akin to
public house A pub (short for public house) is a kind of drinking establishment which is licensed to serve alcoholic drinks for consumption on the premises. The term ''public house'' first appeared in the United Kingdom in late 17th century, and was ...
s in Britain). Some
expatriate An expatriate (often shortened to expat) is a person who resides outside their native country. In common usage, the term often refers to educated professionals, skilled workers, or artists taking positions outside their home country, either ...
residents arriving in the Middle East frequent hookah cafés in lieu of
pubs A pub (short for public house) is a kind of drinking establishment which is licensed to serve alcoholic drinks for consumption on the premises. The term ''public house'' first appeared in the United Kingdom in late 17th century, and was ...
in the region, especially where
prohibition Prohibition is the act or practice of forbidding something by law; more particularly the term refers to the banning of the manufacture, storage (whether in barrels or in bottles), transportation, sale, possession, and consumption of alcoholic ...
is in place and alcohol is not served.


Levant

In the
Levant The Levant () is an approximate historical geographical term referring to a large area in the Eastern Mediterranean region of Western Asia. In its narrowest sense, which is in use today in archaeology and other cultural contexts, it is eq ...
(Syria, Israel, Palestine, Lebanon, Jordan), hookah (sometimes referred to as "", or "") is widely used, and its availability is nearly universal. Hookah has become part of the culture. Smokers are often seen on the side of the streets, parks, bus stops, and other public venues. Cafes are sometimes observed to be fully occupied by hookah smokers, even during late hours of the night. It is not uncommon to see a female smoking hookah. In the Levant, it is very social, and the activity is often accompanied by a game of Tawla (Backgammon), cards, or tea.


Iran

In Iran, the hookah is known as a ''ḡalyān'' ( fa, قليان, قالیون, غلیون, also spelled ''ghalyan'', ''ghalyaan'' or ''ghelyoon''). It is similar in many ways to the Arabic hookah but also differs in several ways. One difference is the uppermost part of the hookah, the "ghalyoun," locally called 'sar' (, i.e. head), where the tobacco is placed. Compared to Turkish hookahs, the Iranian version tends to be somewhat larger. Additionally, the majority of the hose is flexible and covered with soft silk or cloth, while Turkish hookahs often have mouthpieces and partially rigid hoses which are as long as or longer than the flexible part of the hose. Each smoker will typically carry their own personal mouthpiece (called an , ). The is a detachable hookah mouthpiece, and is usually made of wood or metal and can be decorated with valuable or other stones. are considered to be decorative and are a highly personal item. Public smoking venues will often carry disposable or cleanable for the use of smokers who do not carry their own. The exact date of the first use of ḡalyān in Persia is not known. According to Cyril Elgood, it was Abu’l-Fatḥ Gīlānī, a Persian physician at the court of the Mughal emperor Akbar I, who "first passed the smoke of tobacco through a small bowl of water to purify and cool the smoke and thus invented the hubble-bubble or hookah." However, Ahlī Šīrāzī refers to the use of the ḡalyān in one of his poems, thus dating its use to at least as early as the time of Ṭahmāsp I in the late 14th century. Therefore Abu’l-Fatḥ Gīlānī may be credited with the introduction of the Persian ḡalyān in India. Although the
Safavid Safavid Iran or Safavid Persia (), also referred to as the Safavid Empire, '. was one of the greatest Iranian empires after the 7th-century Muslim conquest of Persia, which was ruled from 1501 to 1736 by the Safavid dynasty. It is often conside ...
Shah ʿAbbās I strongly condemned tobacco use, towards the end of his reign smoking ḡalyān and čopoq (a long-stemmed pipe with a small bowl for smoking tobacco, distinct from the ḡ/qalyān, or water pipe.) had become common at every level of society. In schools and learned circles, both teachers and students had ḡalyāns during lessons. Smoking was so popular, that the shah had his own private ḡalyān servant, and the first evidence for the position of hookah tender (ḡalyāndār) dates from this time. At this time, water pipes were made from materials such as glass, pottery, and a particular type of gourd. Due to the unsatisfactory quality of indigenous glass, glass reservoirs were sometimes imported from Venice. In the time of Shah Solaymān in the late 15th and early 16th century, ḡalyāns became more elaborately embellished as their use increased. The wealthy owned gold and silver pipes, and even the general population spent more on ḡalyāns than they did on the basic necessities of life. An emissary of Shah Sultan Husayn, to the court of Louis XV in the early 16th century, on his way to the royal audience at Versailles, had in his retinue an officer holding his ḡalyān, which he used while his carriage was in motion. We have no record indicating the use of ḡalyān at the court of Nāder Shah Afšār, although its use seems to have continued uninterrupted. There are portraits of Karīm Khan Zand and Fatḥ-ʿAlī Shah Qājār which depict them smoking the ḡalyān. Iranians had a special tobacco called ''Khansar'' (, presumably name of the origin city). With Khansar, coals would be put on the Khansar without foil. Khansar has less smoke than the normal tobacco.


Caucasus


Azerbaijan

It is one of the popular entertainment and hangout activities, mostly among youngsters and men in Azerbaijan, especially in
Baku Baku (, ; az, Bakı ) is the capital and largest city of Azerbaijan, as well as the largest city on the Caspian Sea and of the Caucasus region. Baku is located below sea level, which makes it the lowest lying national capital in the world a ...
.


South Asia


Pakistan

Hookah (called chillum or huqqa in Pakistan) is the most common way to consume tobacco among elderly in lower socio-economic and rural people in Pakistan. However, in recent years, use has increased among youth and urban residents, who often consume hookah in cafes.


India

Hookah was popular in India especially during Mughal rule. The hookah then become less popular; however, it is once again garnering the attention of the masses, and cafés and restaurants that offer it as a consumable are popular. The use of hookahs from ancient times in India was not only a custom, but a matter of prestige. Rich and landed classes would smoke hookahs. Tobacco is smoked in hookahs in many villages as per traditional customs. Smoking a tobacco-molasse
shisha
is now becoming popular amongst the youth in India. There are several chain clubs, bars and coffee shops in India offering a wider variety of muʽassels, including non-tobacco versions. Hookah was recently banned in Bangalore. However it can be bought or rented for personal usage or organised parties only.
Koyilandy A Survey of Kerala History, A. Shreedhara Menon ar, Fundriya pt, Pandarani , settlement_type = MunicipalityTaluk , image_skyline = KadaloorPointLight 01.jpg , image_alt = , image_caption ...
, a small fishing town on the west coast of India, once made and exported hookahs extensively. These are known as Malabar Hookhas or Koyilandy Hookahs. Today these intricate hookahs are difficult to find outside of Koyilandy and not much easier to find in Koyilandy itself. Due to their harm to health, hookah has recently been banned in many states in India. There have been numerous raids and bans recently on hookah smoking, especially in
Gujarat Gujarat (, ) is a state along the western coast of India. Its coastline of about is the longest in the country, most of which lies on the Kathiawar peninsula. Gujarat is the fifth-largest Indian state by area, covering some ; and the ninth ...


Nepal

''Hookahs'' (हुक़्क़ा), especially wooden ones, are popular in Nepal. Historically, hookah usage was considered to symbolize elite family status. Today, however, hookahs have become popular among tourists and young people.


Bangladesh

Hookah, as the traditional smoking device, has been commonly used in Bangladesh since the Mughal ages. But mu'assel wasn't introduced in Bangladesh until the early 2000s. Hookah became very popular among the young crowds, and hookah bars and lounges opened up in large numbers to cater to those crowds. However, due to health concerns and unregulated consumption, the government banned hookah in late 2010 and hookah lounges were ordered to shut down. A few hookah lounges were given permission to continue business as they mostly served to foreigners.


Southeast Asia


Philippines

In the Philippines, hookah use was more or less traditionally confined to the minority
Arab Filipino Arab traders have been visiting the Philippines for about 2,000 years, playing a prominent role in the trade networks of the time. They used Southeast Asia for stopovers and trading posts. Since the 14th century, Arab travelers such as Makhdun ...
and
Indian Filipino Indian Filipinos are Filipinos of Indian descent who have historical connections with and have established themselves in what is now the Philippines. The term refers to Filipino citizens of either pure or mixed Indian descent currently residing ...
communities. The custom has also been present in the indigenous
Muslim Filipino Islam was the first-recorded monotheistic religion in the Philippines. Islam reached the Philippines in the 14th century with the arrival of Muslim traders from the Persian Gulf, southern India, and their followers from several sultanates in th ...
community (a considerable
religious minority A minority religion is a religion held by a minority of the population of a country, state, or region. Minority religions may be subject to stigma or discrimination. An example of a stigma is using the term cult with its extremely negative co ...
), where a historical following of Middle Eastern socio-cultural trends led to the hookah being a rare—albeit prestigious—social habit of the nobility in the vital trade hubs of
Mindanao Mindanao ( ) ( Jawi: مينداناو) is the second-largest island in the Philippines, after Luzon, and seventh-most populous island in the world. Located in the southern region of the archipelago, the island is part of an island group of ...
such as
Cotabato Cotabato or North Cotabato ( hil, Aminhan Cotabato; ceb, Amihanang Cotabato; Maguindanaon: ''Pangutaran Kutawatu'', Jawi: ڤڠوترن كوتاواتو; fil, Hilagang Cotabato), officially the Province of Cotabato, is a landlocked province in ...
and
Jolo Jolo ( tsg, Sūg) is a volcanic island in the southwest Philippines and the primary island of the province of Sulu, on which the capital of the same name is situated. It is located in the Sulu Archipelago, between Borneo and Mindanao, and has ...
. Hookah was meanwhile virtually unknown to the predominant Christian Filipinos in
Luzon Luzon (; ) is the largest and most populous island in the Philippines. Located in the northern portion of the Philippines archipelago, it is the economic and political center of the nation, being home to the country's capital city, Manila, as ...
and the
Visayas The Visayas ( ), or the Visayan Islands (Bisayan languages, Visayan: ''Kabisay-an'', ; tl, Kabisayaan ), are one of the three Island groups of the Philippines, principal geographical divisions of the Philippines, along with Luzon and Mindanao ...
before the late 20th century. Presently, hookah use is gaining popularity among younger, more cosmopolitan Christians, particularly with college students and
young adults A young adult is generally a person in the years following adolescence. Definitions and opinions on what qualifies as a young adult vary, with works such as Erik Erikson's stages of human development significantly influencing the definition of ...
who may be underage and thus unable to purchase
cigarette A cigarette is a narrow cylinder containing a combustible material, typically tobacco, that is rolled into thin paper for smoking. The cigarette is ignited at one end, causing it to smolder; the resulting smoke is orally inhaled via the opp ...
s. In the
National Capital Region A capital region, also called a capital district or capital territory, is a region or district surrounding a capital city. It is not always the official term for the region, but may sometimes be used as an informal synonym. Capital regions can exis ...
and other
conurbation A conurbation is a region comprising a number of metropolises, cities, large towns, and other urban areas which through population growth and physical expansion, have merged to form one continuous urban or industrially developed area. In most ca ...
s such as
Metro Cebu Metropolitan Cebu, or simply Metro Cebu, ( ceb, Kaulohang Sugbo; fil, Kalakhang Cebu), is the main urban center of the province of Cebu in the Philippines. Metro Cebu is located along the central eastern portion of the island including the ne ...
and
Metro Davao Metro Davao, officially called Metropolitan Davao ( ceb, Kaulohang Dabaw; fil, Kalakhang Davao), is a metropolitan area in the Mindanao island group, Philippines. It includes the cities of Davao City, Digos, Mati, Panabo, Samal and Tagum and sp ...
, hookahs and flavoured shisha are available in various high-end bars, clubs and "shisha lounges" as well as in traditional Middle Eastern restaurants.


Vietnam

In
Vietnam Vietnam or Viet Nam ( vi, Việt Nam, ), officially the Socialist Republic of Vietnam,., group="n" is a country in Southeast Asia, at the eastern edge of mainland Southeast Asia, with an area of and population of 96 million, making i ...
, shisha has been around for a long time, with the response of young people, so the hobby of smoking shisha is becoming more and more popular. Most people think that smoking shisha is better than smoking due to less nicotine. People can smoke shisha at cafes, karaoke bars and bars in Vietnam.


South Africa

In South Africa, hookah, colloquially known as a ''hubbly bubbly'' or an ''okka pipe'', is popular.


United States and Canada

Hookah was popular in the 1960s and 1970s, although in this era they used open flames rather than coals. In recent years hookah use has increased dramatically in the United States and Canada. Hookah bars and cafes have become popular especially among college students and young adults in big cities across North America. A major reason for this popularity is thought to be the invention of mu’assel in the early 1990s; this moist sweetened and flavored hookah tobacco is popular among young people because the tobacco is masked with a pleasant taste and aroma. There is a growing hookah bar and café industry, especially in inner cities and near universities and colleges where youth and young adults gather. Recently, certain cities, counties, and states have implemented indoor
smoking ban Smoking bans, or smoke-free laws, are public policies, including criminal laws and occupational safety and health regulations, that prohibit tobacco smoking in certain spaces. The spaces most commonly affected by smoking bans are indoor work ...
s, many of which include hookah. In some jurisdictions, hookah businesses can be exempted from the policies through special permits. Some permits, however, have requirements such as the business earning a certain minimum percentage of their revenue from alcohol or tobacco. In cities with indoor smoking bans, hookah bars have been forced to close or switch to tobacco-free muʽassel. In many cities though, hookah lounges have been growing in popularity. From the year 2000 to 2004, over 200 new hookah cafés opened for business, most of them targeted at young adults and located near
college campus A campus is traditionally the land on which a college or university and related institutional buildings are situated. Usually a college campus includes libraries, lecture halls, residence halls, student centers or dining halls, and park-like se ...
es or cities with large Middle-Eastern communities. This activity continues to gain popularity within the post-secondary student demographic. According to a 2018 study, 1.1% of students with some college but no degree, an associate degree or an undergraduate degree reported waterpipe or pipe tobacco product use either every day or some days. As of November 2017, at least 2,082 college or university campuses in the U.S. have adopted 100% smokefree campus policies that attempt to eliminate smoking in indoor and outdoor areas across the entire campus, including residences. Hookah use by youth and adolescents rose from 1998 even as cigarette use decreased: youth hookah use more than doubled from 2011 to 2014 according to the
Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
. However, since then the
US Department of Health and Human Services The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of all Americans and providing essential human services. Its motto is " ...
has stated that older teens have decreased their use of hookahs in recent years. The most recent research, from 2014 to 2018, shows that the percentage of high school seniors who had used a hookah in the last year decreased from 20 percent to 8 percent. Among adolescents and young adults, hookah use is highest among those aged 19–20, and those who live in cities. It is less common in suburban and rural areas. In 2011, 18.5% of 12th-grade students reported having smoked a hookah in the past year. By 2019, 3.4% of highschool students reported having used hookah in the last 30 days.


Health effects

Smoking muʽassel exposes users to many of the same harmful and toxic chemicals found in cigarette smoke. Several of the toxic chemicals in mu’assel smoke can cause cancer, including polycyclic aromatic hydrocarbons (e.g., fluorene and pyrene), heavy metals (e.g., arsenic, chromium, lead), radioactive elements (uranium, polonium, lead), and ultrafine particles. A single session of smoking muʽassel results in far more toxicants inhaled than a session of cigarette smoking, largely because a session of hookah use is much longer than an average session of cigarette smoking: 60 minutes on average for hookah users versus five minutes for a single cigarette. A typical session of smoking muʽassel results in a user inhaling 90,000 ml of smoke versus 500 ml for a cigarette, as well as 1.7 times as much nicotine, 8.4 times as much carbon monoxide, and 36 times as much tar. Muʽassel smoking also exposes users to
heavy metals upright=1.2, Crystals of osmium, a heavy metal nearly twice as dense as lead">lead.html" ;"title="osmium, a heavy metal nearly twice as dense as lead">osmium, a heavy metal nearly twice as dense as lead Heavy metals are generally defined as ...
and is thought to expose users to more
carcinogens A carcinogen is any substance, radionuclide, or radiation that promotes carcinogenesis (the formation of cancer). This may be due to the ability to damage the genome or to the disruption of cellular metabolic processes. Several radioactive substan ...
than cigarettes. Hookah smokers inhale large amounts of carbon monoxide generated from the combustion of mu’assell as well as the charcoal used to burn the mu’assel. Carbon monoxide is a highly toxic odorless gas that can damage the heart and central nervous system. There have been many cases of carbon monoxide poisoning among hookah smokers that require treatment in hospital emergency departments for symptoms such as headache, nausea, vomiting, dizziness, fatigue and weakness. This is sometimes called “hookah sickness.” The charcoal used to heat up the muʽassel increases carbon monoxide and metal inhalation. These toxicants have led the
American Lung Association The American Lung Association is a voluntary health organization whose mission is to save lives by improving lung health and preventing lung disease through education, advocacy and research. History The organization was founded in 1904 to figh ...
,
Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
, and
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
to conclude that smoking muʽassel using a hookah "has many of the same health risks as cigarette smoking." "Although many users think it is less harmful, hookah smoking has many of the same health risks as cigarette smoking." These risks include
lung cancer Lung cancer, also known as lung carcinoma (since about 98–99% of all lung cancers are carcinomas), is a malignant lung tumor characterized by uncontrolled cell growth in tissue (biology), tissues of the lung. Lung carcinomas derive from tran ...
,
respiratory disease Respiratory diseases, or lung diseases, are pathology, pathological conditions affecting the organs and tissues that make gas exchange difficult in Breathing, air-breathing animals. They include conditions of the respiratory tract including the t ...
, low birth weight in babies, increased risk of respiratory disease in babies,
heart disease Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, hea ...
and
artery An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pul ...
clogging, as well as
oral The word oral may refer to: Relating to the mouth * Relating to the mouth, the first portion of the alimentary canal that primarily receives food and liquid **Oral administration of medicines ** Oral examination (also known as an oral exam or oral ...
,
stomach The stomach is a muscular, hollow organ in the gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach i ...
,
esophagus The esophagus (American English) or oesophagus (British English; both ), non-technically known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the ...
and
bladder cancer Bladder cancer is any of several types of cancer arising from the tissues of the urinary bladder. Symptoms include blood in the urine, pain with urination, and low back pain. It is caused when epithelial cells that line the bladder become mali ...
s. Herbal muʽassel and shisha poses similar risks to its tobacco-containing counterpart: smoke from herbal muʽassel contains equal or greater levels of carbon monoxide, nitric oxide, aldehydes, tar, and carcinogenic
polycyclic aromatic hydrocarbons A polycyclic aromatic hydrocarbon (PAH) is a class of organic compounds that is composed of multiple aromatic rings. The simplest representative is naphthalene, having two aromatic rings and the three-ring compounds anthracene and phenanthrene. P ...
(PAH) as tobacco-containing smoke. These chemicals contribute to cancers, heart disease, and lung disease. In addition, mu’assell contains nicotine, which smokers inhale. Nicotine is addictive, which can make quitting hookah difficult and cause withdrawal symptoms such as irritability and depression when people go without smoking hookah for an extended time. Smoking muʽassel in a hookah also releases
secondhand smoke Passive smoking is the inhalation of tobacco smoke, called secondhand smoke (SHS), or environmental tobacco smoke (ETS), by persons other than the intended "active" smoker. It occurs when tobacco smoke enters an environment, causing its inhalat ...
that harms the health of those around the smoker. Secondhand smoke from hookahs contains carbon monoxide, PAH, aldehydes, ultrafine particles (<2.5μm), and respirable particulate matter (particles small enough to enter the lungs). Studies of hookah lounges in
Virginia Virginia, officially the Commonwealth of Virginia, is a state in the Mid-Atlantic and Southeastern regions of the United States, between the Atlantic Coast and the Appalachian Mountains. The geography and climate of the Commonwealth ar ...
have found that hookah lounges have worse air quality than comparable restaurants that allow indoor cigarette smoking. Acute effects of exposure to secondhand smoke from hookahs including wheezing, nasal congestion, and chronic cough, although long term effects have yet to be studied. The detrimental effects of secondhand smoke from hookahs apply equally to tobacco-free muʽassel or shisha: one study found that herbal hookah smoke contains carcinogens equal or greater to that of hookah smoke with tobacco, in addition to PAH, carbon monoxide, and metals.


See also

* Smoking in Syria


References

{{DEFAULTSORT:Mu'assel Arab culture Arabic words and phrases Tobacco in the United Arab Emirates Tobacco in Egypt Tobacco smoking