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Pediatr Res 93(7):19591968 Kadhum M, Jaffery A, Haq A, Bacon J, Madden B (2014) Measuring the acute cardiovascular effects of shisha smoking: a cross-sectional study

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Blow gently into a disposable tissue to avoid spreading germs and pushing mucus into your ears or other parts of your sinuses

They caution that such evidence should be considered preliminary, the results should be interpreted with caution, and it is not possible to establish causality from their research